The costs of social anxiety disorder: the role of symptom severity and comorbidities

TY - JOUR

T1 - The costs of social anxiety disorder: the role of symptom severity and comorbidities

AU - Stuhldreher, Nina

AU - Leibing, Eric

AU - Leichsenring, Falk

AU - Beutel, Manfred E

AU - Herpertz, Stephan

AU - Hoyer, Juergen

AU - Konnopka, Alexander

AU - Salzer, Simone

AU - Strauss, Bernhard

AU - Wiltink, Joerg

AU - König, Hans-Helmut

N1 - Copyright © 2014 Elsevier B.V. All rights reserved.

PY - 2014/8/1

Y1 - 2014/8/1

N2 - BACKGROUND: Social anxiety disorder (SAD) is associated with low direct costs compared to other anxiety disorders while indirect costs tend to be high. Mental comorbidities have been identified to increase costs, but the role of symptom severity is still vague. The objective of this study was to determine the costs of SAD, and to explore the impact of symptoms and comorbidities on direct and indirect costs.METHODS: Baseline data, collected within the SOPHO-NET multi-centre treatment study (N=495), were used. Costs were calculated based on health care utilization and lost productivity. Symptom severity was measured with the Liebowitz-Social-Anxiety-Scale; comorbidities were included as covariates.RESULTS: Total 6-month costs were accrued to €4802; 23% being direct costs. While there was no significant association with SAD symptom severity for direct costs, costs of absenteeism increased with symptom severity in those with costs >0; comorbid affective disorders and eating disorders had an additional effect. Self-rated productivity was lower with more pronounced symptoms even after controlling for comorbidities.LIMITATIONS: As the study was based on a clinical sample total costs were considered, rather than net costs of SAD and no population costs could be calculated.DISCUSSION: The burden associated with lost productivity was considerable while costs of healthcare utilization were rather low as most patients had not sought for treatment before. Efforts to identify patients with SAD earlier and to provide adequate treatment should be further increased. Mental comorbidities should be addressed as well, since they account for a large part of indirect costs associated with SAD.

AB - BACKGROUND: Social anxiety disorder (SAD) is associated with low direct costs compared to other anxiety disorders while indirect costs tend to be high. Mental comorbidities have been identified to increase costs, but the role of symptom severity is still vague. The objective of this study was to determine the costs of SAD, and to explore the impact of symptoms and comorbidities on direct and indirect costs.METHODS: Baseline data, collected within the SOPHO-NET multi-centre treatment study (N=495), were used. Costs were calculated based on health care utilization and lost productivity. Symptom severity was measured with the Liebowitz-Social-Anxiety-Scale; comorbidities were included as covariates.RESULTS: Total 6-month costs were accrued to €4802; 23% being direct costs. While there was no significant association with SAD symptom severity for direct costs, costs of absenteeism increased with symptom severity in those with costs >0; comorbid affective disorders and eating disorders had an additional effect. Self-rated productivity was lower with more pronounced symptoms even after controlling for comorbidities.LIMITATIONS: As the study was based on a clinical sample total costs were considered, rather than net costs of SAD and no population costs could be calculated.DISCUSSION: The burden associated with lost productivity was considerable while costs of healthcare utilization were rather low as most patients had not sought for treatment before. Efforts to identify patients with SAD earlier and to provide adequate treatment should be further increased. Mental comorbidities should be addressed as well, since they account for a large part of indirect costs associated with SAD.

KW - Absenteeism

KW - Adult

KW - Anxiety Disorders

KW - Comorbidity

KW - Cost of Illness

KW - Efficiency

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Self Report

KW - Severity of Illness Index

KW - Social Behavior

KW - Young Adult

U2 - 10.1016/j.jad.2014.04.039

DO - 10.1016/j.jad.2014.04.039

M3 - SCORING: Journal article

C2 - 24882183

VL - 165

SP - 87

EP - 94

JO - J AFFECT DISORDERS

JF - J AFFECT DISORDERS

SN - 0165-0327

ER -