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Economic Consequences of Comorbid Depression, Anxiety, and Allergic Rhinitis

Received January 26, 1999; revised May 12, 1999; accepted May 28, 1999. From Behavioral Health Sciences, United Behavioral Health; Department of Medicine, National Jewish Medical and Research Center; Department of Psychiatry, University of Colorado Health Sciences Center; and the The MEDSTAT Group. Address correspondence and reprint requests to Dr. Cuffel, United Behavioral Health, 425 Market Street, 27th Floor, San Francisco, CA 94105–2426.

The present study extends prior work on the association between allergic rhinitis (AR) and common mental disorders by testing three related hypotheses: 1) that AR is associated with increased rates of depression and anxiety disorders in a large insured population, 2) comorbid AR, depression, and anxiety are associated with increased health and mental health expenditures, and 3) allergy treatment moderates the association between increased expenditures and comorbid AR, depression, and anxiety. Data are from MARKETSCAN®, a large health care claims database of over 600,000 privately insured persons. Results indicate that AR is associated with higher rates of depression and anxiety disorder. Outpatient health care expenditures were increased by an average annual amount of $207 when AR and anxiety disorder were comorbid and $363 when AR and depression were comorbid. Finally, prescription treatment of AR moderated the increased expenditures associated with comorbidity.

Key Words: Depression • Anxiety • Economics

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