Leo Sher, M.D.

A research work, “Comparison of overall survival and healthcare resource utilization among patients with major depressive disorder with or without psychiatric emergency admission: A real-world study from Hungary” has just been published in the Journal of Affective Disorders (1).

Individuals with major depressive disorder (MDD) hospitalized for psychiatric emergencies (PE) are a high-risk population. The authors used 2009-2020 data from the Hungarian National Health Insurance Fund (NHIF) database to examine overall survival and healthcare resource utilization among MDD patients with PE (MDD-PE) vs without PE (MDD-nonPE). The NHIF is a government health insurance system which covers almost 100% of the Hungarian population.

Patients with MDD were selected if they had at least two records of MDD diagnosis, or one record of MDD diagnosis and one prescription of antidepressant within 90 days of each between January 1, 2010, and December 31, 2020. MDD-PE patients had a history of inpatient hospitalization in a psychiatric ward for acute treatment, and/or a visit to an emergency department with ≥1 psychiatric and/or suicidal condition among the discharge diagnoses. Patients with a diagnosis of bipolar disorder, dementia, organic mood disorders or schizophrenia were not included in the study. Patients in the MDD-PE and MDD-nonPE groups were matched on age, gender, location of residence, and selected pre-index comorbidities. 28,988 MDD-PE and 28,988 MDD-nonPE patients were included in the analysis.

MDD-PE patients had significantly higher mean all-cause inpatient admissions per patient per year (PPPY) (3.9 vs 1.4, p < 0.001) and mean MDD-related inpatient admissions PPPY (2.3 vs 0.7, p < 0.001) in comparison to the matched MDD-nonPE patients. Among patients with a history of inpatient admissions, MDD-PE patients had significantly more all-cause (65.4 vs 17.4 days, p < 0.001) and MDD-related (25.9 vs 8.7 days, p < 0.001) days in hospital per year than the matched MDD-nonPE patients. The authors suggest that their findings underscore the significance of a need for comprehensive care for patients with MDD following their admission to an acute psychiatric ward or visit to an emergency department.

Reference

1. Rihmer Z, Dome P, Szekeres G, Feher L, Kunovszki P, Gimesi-Orszagh J, Cai Q, El Khoury AC, Bitter I. Comparison of overall survival and healthcare resource utilization among patients with major depressive disorder with or without psychiatric emergency admission: A real-world study from Hungary. J Affect Disord. 2025 Mar 1;372:184-190. doi: 10.1016/j.jad.2024.12.014. Epub 2024 Dec 5.