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Open Access 01-12-2021 | Mood Disorders | Research article

Association of depression symptom severity with short-term risk of an initial hospital encounter in adults with major depressive disorder

Authors: Jennifer Voelker, Kun Wang, Wenze Tang, Jinghua He, Ella Daly, Christopher D. Pericone, John J. Sheehan

Published in: BMC Psychiatry | Issue 1/2021

Abstract

Background

Despite the availability of pharmacologic and nonpharmacologic treatment options, depression continues to be one of the leading causes of disability worldwide. This study evaluated whether depression symptom severity, as measured by PHQ-9 score, of patients diagnosed with MDD is associated with short-term risk of a hospital encounter (ER visit or inpatient stay).

Methods

Adults with ≥1 PHQ-9 assessment in an outpatient setting (index date) and ≥ 1 MDD diagnosis within 6 months prior were included from the de-identified Optum Electronic Health Record database (April 2016–June 2019). Patients were categorized by depression symptom severity based on PHQ-9 scores obtained by natural language processing. Crude rates, adjusted absolute risks, and adjusted relative risks of all-cause and MDD-related hospital encounters within 30 days following assessment of depression severity were determined.

Results

The study population consisted of 280,145 patients with MDD and ≥ 1 PHQ-9 assessment in an outpatient setting. Based on PHQ-9 scores, 26.9% of patients were categorized as having none/minimal depression symptom severity, 16.4% as mild, 24.7% as moderate, 19.6% as moderately severe, and 12.5% as severe. Among patients with none/minimal, mild, moderate, moderately severe, and severe depression, the adjusted absolute short-term risks of an initial all-cause hospital encounter were 4.1, 4.4, 4.8, 5.6, and 6.5%, respectively; MDD-related hospital encounter adjusted absolute risks were 0.8, 1.0, 1.3, 1.6, and 2.1%, respectively. Compared to patients with none/minimal depression symptom severity, the adjusted relative risks of an all-cause hospital encounter were 1.60 (95% CI 1.50–1.70) for those with severe, 1.36 (1.29–1.44) for those with moderately severe, 1.18 (1.12–1.25) for those with moderate, and 1.07 (1.00–1.13) for those with mild depression symptom severity.

Conclusions

These study findings indicate that depression symptom severity is a key driver of short-term risk of hospital encounters, emphasizing the need for timely interventions that can ameliorate depression symptom severity.

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Title: Association of depression symptom severity with short-term risk of an initial hospital encounter in adults with major depressive disorder
Authors: Jennifer Voelker
Kun Wang
Wenze Tang
Jinghua He
Ella Daly
Christopher D. Pericone
John J. Sheehan
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Mood Disorders
Affective Disorder
Published in: BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-021-03258-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Association of depression symptom severity with short-term risk of an initial hospital encounter in adults with major depressive disorder

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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