How Bad Is Depression? Preference Score Estimates from Depressed Patients and the General Population

OBJECTIVE: To compare depression health state preference scores across four groups: (1) general population, (2) previous history of depression but not currently depressed, (3) less severe current depression, and (4) more severe current depression. DATA SOURCES: Primary data were collected from 95 general population, 163 primary care, and 83 specialty mental health subjects. STUDY DESIGN: Stratified sampling frames were used to recruit general population and patient subjects. Subjects completed cross-sectional surveys. Key variables included rating scale and standard gamble scores assigned to depression health state descriptions developed from the Patient Health Questionnaire-9 (PHQ-9) and SF-12. DATA COLLECTION/EXTRACTION METHODS: Each subject completed an in-person interview. Forty-nine subjects completed test/retest reliability interviews. PRINCIPAL FINDINGS: Depressed patient preference scores for three of six SF-12 depression health states were significantly lower than the general population using the rating scale and two of six were significantly lower using standard gamble. Depressed patient scores for five of six PHQ-9 depression health states were significantly lower than the general population using the rating scale and two of six were significantly lower using standard gamble. CONCLUSIONS: Depressed patients report lower preference scores for depression health states than the general population. In effect, they perceived depression to be worse than the general public perceived it to be. Additional research is needed to examine the implications for cost-effectiveness ratios using general population preference scores versus depressed patient preference scores.