Patient Characteristics and Healthcare Resource Utilization Among Individuals with Major Depressive Disorder in the Veterans Affairs Administration System

Background: Major Depressive Disorder (MDD) is a prevalent psychiatric disorder, affecting an estimated one in five U.S. adults during their lifetime. This study aims to assess the clinical and demographic characteristics, treatment modalities, and healthcare resource utilization (HCRU) among individuals with MDD within the Veterans Affairs (VA) Administration system.
Methods: This retrospective cohort study utilized VA system claims data from January 2000 to July 2022, sourced from the VA Informatics and Computing Infrastructure (VINCI). Adults diagnosed with MDD using ICD-9/10 codes were included. The date of the initial MDD claim served as the index date. The study population was followed at least one year until the earliest of the last recorded VA activity, death, or July 31, 2022.
Results: The study included 1,733,050 individuals (mean age: 55.7, 87.5% male). Common comorbid conditions during baseline period were obesity (BMI > 30, 42.1%), diabetes (26.5%), substance use (20.9%), anxiety (20.3%), and sleep disorders (12.9%). Within the first year following the index date, the most frequently prescribed medications were sertraline (20.8%) and trazodone (19.1%). Additionally, 41.8% had engaged in at least one therapy session post-diagnosis. The mean number of mental health clinic visits and psychotherapy sessions were approximately 6.5 and 1.8 per year, respectively.
Conclusion: The VA system includes a large number of MDD patients with significant comorbidities and high HCRU. These findings highlight the substantial burden of MDD and the opportunity to continue advancing treatment strategies for these patients.