10002674 J Clin Psychiatry / Document Archive

Psychiatrist.com Home    Keyword Search

Close [X]

Search Our Sites

Enter search terms below (keywords, titles, authors, or subjects). Then select a category to search and press the Search button. All words are assumed to be required. To search for an exact phrase, put it in quotes. To exclude a term, precede it with a minus sign (-).

Keyword search:

Choose a category:

Choosing the appropriate category will greatly improve your chances of finding the best match.

All files at our sites: J Clin Psychiatry, Primary Care Companion, CME Institute, and MedFair

Search materials from our journals:

Abstracts from The Journal of Clinical Psychiatry, 1996–present, both regular issues and supplements

PDFs of the full text of The Journal of Clinical Psychiatry, 1996–present, both regular issues and supplements (Net Society Platinum [paid subscribers])

PDFs of the full text of The Primary Care Companion to The Journal of Clinical Psychiatry, 1999–present

Search CME offerings:

CME Institute, including CME from journals , supplements, and Web activities for instant CME credit (Net Society Gold [registered users]); also includes information about our CME program

CME activities from regular issues of The Journal of Clinical Psychiatry (Net Society Gold [registered users])

CME Supplements from The Journal of Clinical Psychiatry (Net Society Gold [registered users])


The article you requested is

Major Depressive Disorder, Somatic Pain, and Health Care Costs in an Urban Primary Care Practice.

J Clin Psychiatry 2006;67:1232-1239
Copyright 2006 Physicians Postgraduate Press, Inc.

To view this item, select one of the options below.

    1. Purchase this PDF for $40
      If you are not a paid subscriber, you may purchase the PDF.
      (You'll need the free Adobe Acrobat Reader.)
    2. Subscribe
      Receive immediate full-text access to JCP. You can subscribe to JCP print + online for $166 individual.
      JCP's 75th AnniversaryCelebrate!
      Celebrate JCP's 75th Anniversary with a special online-only subscription price of $75.
    1. Activate
      If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
    2. Sign in
      As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
  1. Did you forget your password?

Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send an email


Objective: To evaluate the extent to which pain severity contributes to the increased medical care costs associated with depression in primary care.

Method: A systematic sample of primary care patients (N = 1028) from an urban practice were assessed between April 1, 2002, and January 16, 2003, with the DSM-IV Primary Care Evaluation of Mental Disorders Patient Health Questionnaire, the Sheehan Disability Scale, a medical illness checklist, and the Medical Outcomes Study 12-Item Short Form Health Survey, which includes a measure of pain interference with daily activities. Medical charges for inpatient, outpatient, and emergency department services were assessed for the 6-month periods preceding and following the index medical visit. Patients with and without major depressive disorder (MDD) were first compared with respect to clinical characteristics and median medical charges. Mean predicted medical care charges were then compared among 4 patient groups: (1) No MDD/Low Pain Interference, (2) No MDD/High Pain Interference, (3) MDD/Low Pain Interference, and (4) MDD/High Pain Interference.

Results: As compared to patients without MDD (N = 821), those with MDD (N = 207) had significantly higher predicted mean medical care charges ($19,838 vs. $6268; t = 3.3, p = .001) after controlling for age and gender and were significantly more likely to report at least moderate pain-related interference in daily activities (MDD: 69.1% vs. no MDD: 38.6%; chi2 = 61.3, df = 1, p < .0001). Mean predicted medical care charges of patients with MDD and at least moderate pain-related interference were on average 2.33 times (95% CI = 1.34 to 4.05) as high as those for patients with MDD and little or no pain-related interference. Among patients with at least moderate pain-related interference, MDD was associated with significantly greater mean predicted charges (mean = $28,598/year with MDD vs. $11,031/year without MDD). However, among patients with lower levels of pain-related interference, MDD was not associated with greater mean predicted medical charges (mean = $2306/year with MDD vs. $3560/year without MDD).

Conclusion: In this urban primary care practice, major depressive disorder is associated with increased health care costs, but only among patients with moderate to extreme pain-related interference in daily activities.