Clinical depression costs economy up to 22 billion euros each year

Four million Germans suffer from depression. Each year, depression drives some 7,000 people to suicide. And at the same time it costs the German economy as  much as 22 billion euros. That's the result of a current health report from Allianz Deutschland AG and the Rhineland-Westphalian Institute for Economic Research (RWI), entitled "Depression – How an Illness Weighs on our Souls."

According to a WHO projection, by 2030 depression will be the most common illness in industrialized nations. "Emotional stress, burnout and depression will thus become a cost factor that can no longer be ignored," says Christian Molt, member of the Board of Management of health insurer Allianz Private Krankenversicherungs-AG. Allianz too is seeing substantial cost increases for benefits for emotional illness, a significant portion of them for treating depression. It commissioned RWI to calculate how much the illness costs Germany as a whole.

The direct and indirect costs of depression in Germany are between 15.5 and 22 billion euros each year. From 2002 to 2008 alone, direct costs of the illness increased one-third, to 5.2 billion euros. Indirect costs are incomparably higher, at 10.3 to 16.7 billion euros. Of that cost, 9.3 billion euros is because depressed people go to work instead of staying home and getting treatment. The cost of reduced productivity from depressed employees on the job (known as "presenteeism") thus does by far the greatest economic damage.

Christian Molt: "Emotional stress, burnout and depression will thus become a cost factor that can no longer be ignored"

So far medicine has been unable to understand the exact mechanism of depression, so as to approach it even more specifically

Allianz Deutschland AG intends its current health report, "Depression – How an Illness Weighs on Our Souls," to help lift the social taboos and stigma on depression. For the first time, it attempts to view the problem from both an economic and a medical perspective, in dialog with specialists.

"We want depression to be understood for what it is, a serious illness," says Molt. "Patient autonomy is especially important in psychiatric care, and can be achieved only with extensive information, transparency, and education." That's important because depressed people in particular often get the wrong treatment, or too little treatment, or even too much treatment. Figures from the Depression Expertise Network show that depression is recognized accurately in only about 30 out of every 100 patients with the illness. And of those 30, less than 10 receive adequate treatment. That's why it's especially important in depression to initiate the right care at the right time and the right place, with excellent quality, as quickly as possible and with the patient's support.

Medication and psychotherapy have provided medicine with instruments that can lead to good clinical results in some cases of depression. "But so far medicine has been unable to understand the exact mechanism of depression, so as to approach it even more specifically," says Prof. Florian Holsboer, Director of Munich's Max Planck Institute for Psychiatry, as well as a member of the Board of Medical Advisors of Allianz Private Krankenversicherung and one of the authors of the report.

Holsboer has a vision of personalized medicine in which each individual's depression will be treated as a separate illness with its own therapy. In addition to researching new therapeutic approaches, he says it's important to improve prevention and early recognition of the condition. "Much too often, depression is still detected too late or not at all, and thus is treated too late or not at all," Holsboer says. He also points out that there is a dramatic shortage of psychiatrists in this regard. Today, only one out of every ten referrals to psychiatric clinics comes from a psychiatrist.

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