The highest price is what the sick and their families “pay”, but the disease also has a significant economic impact both in terms of social and social security spending, in addition to the direct costs borne by citizens
It is not always thought that i depressive disordersin addition to interfering with the quality of life of individuals who suffer from it and their families, they represent a problem for society as a whole, which is also reflected in the costs. “In recent years, following analyzes carried out also by my research center, it has emerged that mental disorders represent one of the largest items of expenditure as regards both the National Health System (NHS) and that category of public expenditure that goes under the name of social expenditure, the expenditure for the social security system, in addition of course to the direct costs borne by citizens (out of pocket) “says Francesco Saverio Mennini, professor of health economics at the Tor Vergata University of Rome and President of SiHTA, the Italian Society of Health Technology Assessment. «Research carried out indicates that the costs incurred by the National Health Service, as regards the depressive disorder, they amount to one billion 250 million euros every year, almost 11 percent of public health expenditure which in 2019 was about 115 billion euros. The most important item of expenditure for the health service is due to specialist outpatient visits ».
The price to pay
But these are only the direct healthcare costs. Alongside there are the “indirect costs”, a term used to indicate those costs related to loss of productivity, as a result of the tax loss and costs borne by the social security system. “The indirect costs are the masters, as they represent 70 percent of the total costs of this disorder,” says Mennini. «The ordinary disability allowance and the disability pension are now awarded to about eleven thousand people suffering from major depression. And they are constantly increasing: from 2009 to 2015 there was a increase by nearly 21 percent. We must pay close attention to these data, also in light of what unfortunately we will verify following the analysis of the data from the Covid period. In the analysis period, more than 700 million euros were spent on these two types of benefits, on average 110 million per year just for the ordinary disability allowance and the disability pension. Data that make us understand what the dimension of the problem is, even if only in reference to social security expenditure. The future goal will be to better organize and structure the management of people suffering from a depressive disorder, to ensure better treatment and better care, aiming at a reduction in disability also accompanied by cost containment. To this end, it will be important to activate prevention campaigns, early taking in charge and strengthen services, especially territorial, also thanks to the resources made available by the National Recovery and Resilience Plan (Pnrr), as well as reducing the gap between the Regions. “.
The duration
This significant social impact is related to real depressive disorders, which must be kept separate from those periods of normal sadness through which everyone goes through at one time or another in life. «The real depressive disorder has symptoms precise »says Antonio Vita, full professor of psychiatry at the University of Brescia and director of the Department of mental health and addictions of the territorial social and health care agency of the Civil Hospitals of Brescia. “Symptoms such as depressed mood almost every day for an extended period – at least two weeks – or a marked decrease in interest or pleasure in the usual activities of life. This can be associated with somatic symptoms such as loss of appetite and weight, or an increased appetite, especially for sweet foods. And also insomnia, with awakenings in the middle of the night or very early in the morning, accompanied by negative thoughts. There may also be psychomotor slowdown and lack of energy, feelings of inability and self-depreciation, cognitive deficit, thoughts related to the idea of death ».
Biological vulnerability
It is a pathology that causes a lot of suffering as well as a decline in social and work functions. The most severe form, major depression, affects 5-6 percent of the population over the course of life, especially in middle and elderly age, although many young people have been involved in the pandemic. “Upstream of a depressive disorder there may be a biological vulnerability, often associated with stressful events, such as bereavement and separation,” says Vita. “But there are also early events in a person’s history that make them more vulnerable, as well as social factors, poverty, lack of support, or having physical illness. It is a continuous interaction between genetic and environmental factors ».
The treatments
Fortunately, there are many options for treating depressive disorders that have evolved over the past 50 years. «The treatments are aimed at resolving symptoms, recovering good functioning and reducing the risk of relapse. However, today we know that there are forms that do not respond well to treatments. About 25 percent of cases are what is called resistant depression, a term for cases that don’t respond to multiple drug treatments. “However, we also have various forms of non-pharmacological treatment available, such as psychotherapies, especially those with a cognitive-behavioral orientation, based on the correction of thought distortions, which in depressed people tend to emphasize the negative aspects of existence and neglect the positive ones, but also on behavioral changes, such as an improvement in lifestyles or a more functional organization of the day, with an increase in motor activity »concludes the expert.
March 3, 2022 (change March 3, 2022 | 19:06)
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