Hostname: page-component-669899f699-2mbcq Total loading time: 0 Render date: 2025-04-27T01:15:38.388Z Has data issue: false hasContentIssue false
  • English
  • Français

Costs and Offset Effect in Panic Disorders

Published online by Cambridge University Press:  06 August 2018

L. Salvador-Carulla ,
J. Seguí ,
P. Fernández-Cano  and
J. Canet
L. Salvador-Carulla*
Affiliation:
University of Cadiz
J. Seguí
Affiliation:
Hospital de La Alianza, Barcelona
P. Fernández-Cano
Affiliation:
Regional Government of Castilla-La Mancha, Toledo
J. Canet
Affiliation:
Centro de Psiquiatria y Psicologia, Barcelona, Spain
*
Luis Salvador-Carulla, Associate Professor of Psychiatry, Facultad de Medicina, Universidad de Cádiz, Pza. Fragela s/n, 11003-Cádiz (Spain)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background. The study is aimed at assessing the costs before and after the diagnosis and the provision of effective treatment for panic disorder (PD), and the offset effect related to the psychiatric encounter.

Method. A 24-month prepost design was used to collect data on clinical status and health care services utilisation in a natural environment. The 61 PD patients' assessment included the SCID-UP, ratings on general functioning, improvement, severity of symptoms and level of disability. All health care services used and lost workdays were recorded.

Results. Both sociodemographic characteristics and the outcome show that this was a standard group of PD patients, who received effective treatment for their condition. The total direct costs of health care use during the previous year and the year after the diagnosis were, respectively, US$ 29 1 58 and US$ 46 256. The indirect costs of lost productivity were US$ 65 643 in period I and US$ 13 883 in period II.

Conclusions. A strong offset effect (94%) has been found in this study, significantly greater than the one described for psychiatric disorders as a whole. The costs of nondiagnosis are usually overlooked when estimating the global costs of PD. Methods for improving early detection of PD may substantially reduce the costs incurred before diagnosis.

Type
II. Economic Aspects of Programmes Dealing with Anxiety Disorders
Information
The British Journal of Psychiatry , Volume 166 , Issue S27: Economics of Anxiety and Depression , April 1995 , pp. 23 - 28
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Borus, J. F., Olendzki, M. C., Kessler, L., et al (1985) The “Offset Effect” of mental health treatment on ambulatory medical care. Utilization and charges. Archives of General Psychiatry, 42, 573–580.Google Scholar
Boyd, J. H. (1986) Use of mental health services for the treatment of panic disorder. American Journal of Psychiatry, 143, 1569–1574.Google Scholar
Breier, A., Charney, D. S., Heninger, G. R. (1986) Agoraphobia with panic attacks. Archives of General Psychiatry, 43, 1209–1036.CrossRefGoogle ScholarPubMed
Edlund, M. J. & Swann, A. C. (1987) The economic and social cost of panic disorders. Hospital and Community Psychiatry, 38, 1277–1280.Google Scholar
Hankin, J. R., Kessler, L. G., Goldberg, I. D., et al (1983) A longitudinal study of offset in the use of nonpsychiatric services following specialized mental health care. Medical Care, 21, 1099–1110.Google Scholar
Holder, H. D. & Blose, J. O. (1987) Changes in health care costs and utilization associated with mental health treatment. Hospital and Community Psychiatry, 38, 1070–1075.Google Scholar
Holder, H. D. & Blose, J. O. (1987) Mental Health Treatment and the Reduction of Health Care Costs: A Four-Year Study of US Federal Employees’ enrollment with the Aetna Life Insurance Company. Advances in Health Economics and Health Services Research, 8, 157–174.Google Scholar
Keller, M. B. & Baker, L. A. (1992) The clinical course of panic disorder and depression. Journal of Clinical Psychiatry, 53 (suppl.), 5–8.Google Scholar
Klerman, G. L. (1992) Treatments for panic disorder. Journal of Clinical Psychiatry, 53 (suppl.), 14–19.Google Scholar
Klerman, G. L., Weismann, M. M., Ouellette, R., et al (1991) Panic attacks in the community. Journal of the American Medical Association, 265, 742–746.CrossRefGoogle ScholarPubMed
Lepine, J. P., Chignon, J. M. & Teherani, M. S. (1993) Suicide attempts in patients with panic disorders. Archives of General Psychiatry, 50, 144–149.Google Scholar
Levenson, J. L., Hamer, R. M. & Rossiter, L. F. (1992) A randomized controlled study of psychiatric consultation guided by screening in general medical in-patients. American Journal of Psychiatry, 149, 631–637.Google Scholar
Markowitz, J. S., Weissman, M. M., Oullette, R., et al (1989) Quality of life in panic disorder. Archives of General Psychiatry, 46, 984–992.Google Scholar
Mavissakalian, M. & Perel, J. M. (1992) Clinical experiments in maintenance and discontinuation of imipramine therapy in panic disorder with agoraphobia. Archives of General Psychiatry, 49, 318–323.CrossRefGoogle ScholarPubMed
Mumford, E., Schlesinger, H. J., Glass, G. V., et al (1984) A new look at evidence about reduced cost of medical utilization following mental health treatment. American Journal of Psychiatry, 141, 1145–1158.Google Scholar
Noyes, R. Jr, Reich, J., Christiansen, J., et al (1990) Outcome in panic disorder. Relationship to diagnostic subtypes and comorbidity. Archives of General Psychiatry, 47, 809–818.Google Scholar
Rice, D. P. & Miller, L. S. (1993) The economic burden of mental disorders. Advances in Health Economics and Health Services Research, 14, 37–53.Google Scholar
Salvador-Carulla, L., Segui, J., Fernandez-Cano, P., et al (1994) Assessment of costs distribution and cost-offset after diagnosis of panic disorders. In Current Therapeutical Approaches in Panic and other Anxiety Disorders (eds Darcourt, G., Mendlewicz, J., Racagni, G., et al), pp. 61–70. International Academy of Biomedicine and Drug Research. Basel: Karger.Google Scholar
Siegel, L., Jones, W. C. & Wilson, J. O. (1990) Economic and life consequences experienced by a group of individuals with panic disorder. Journal of Anxiety Disorders, 4, 201–211.CrossRefGoogle Scholar
Von Korff, M., Katon, W. & Lin, E. (1990) Psychological distress, physical symptoms, utilization and the cost-offset effect. In Psychological Disorders in General Medical Settings (eds Sartorius, N., Goldberg, D., de Girolamo, G., et al), pp. 159–169. Toronto: Hogrefe and Huber.Google Scholar
World Bank (1993) World Development Report 1993. Washington: Oxford University Press.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.