Health service use by adults with depression: community survey in five European countries - Evidence from the ODIN study

Background: Little is known about patterns of healthcare use by people with depression in Europe. Aims: To examine the use and cost of services by adults with depressive or adjustment disorders in five European countries, and predictive factors. Method: People aged 18-65 years with depressive or adjustment disorders (n=427) in Ireland, Finland, Norway, Spain and the UK provided information on predisposition (demographics, social support), enablement (country, urban/rural, social function) and need (symptom severity, perceived health status) for services. Outcome measures were self-reported use Client Services Receipt Interview and costs of general practice, generic, psychiatric or social services in the past 6 months. Results: Less frequent use was made of generic services in Norway and psychiatric services in the UK. Severity of depression, perceived health status, social functioning and level of social support were significant predictors of use; the number of people able to provide support was positively associated with greater health service use. Conclusions: Individual participant factors provided greater explanatory power than national differences in healthcare delivery. The association between social support and service use suggests that interventions may be needed for those who lack social support.