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Background: Patients with major depressive disorder (MDD) hospitalized for psychiatric emergencies (PE) represent a high-risk population, requiring immediate intervention. Overall survival and healthcare resource utilization were evaluated among MDD patients with PE (MDD-PE) vs without PE (MDD-nonPE) using data from the Hungarian National Health Insurance Fund database (2009 to 2020)., Methods: Patients with MDD were selected if they had at least (i) 2 records of MDD diagnosis, or (ii) 1 record of MDD diagnosis and 1 prescription of antidepressant within 90 days of each other between 01 January 2010 and 31 December 2020. MDD-PE patients should have an inpatient hospitalization in a psychiatric ward dedicated for acute treatment, and/or a visit to an emergency department with ≥1 psychiatric and/or suicidal condition among the discharge diagnoses. Patients in the MDD-PE and MDD-nonPE cohorts were matched using a 1:1 propensity score matching algorithm based on age, gender, location of residence, and selected pre-index comorbidities., Results: 28,988 MDD-PE and 28,988 MDD-nonPE patients were included after propensity score matching. Overall survival was significantly shorter among MDD-PE vs matched MDD-nonPE patients (HR: 1.40, 95%CI: 1.33-1.48; p < 0.001). MDD-PE (vs matched MDD-nonPE) patients had significantly higher mean all-cause inpatient admissions (3.9 vs 1.4, p < 0.001) per patient per year (PPPY), and MDD-related inpatient admissions (2.3 vs 0.7, p < 0.001) PPPY with more days in hospital PPPY (all-cause: 65.4 vs 17.4 days; MDD-related: 25.9 vs 8.7 days)., Conclusions: Findings emphasize the need for comprehensive care prioritizing increased vigilance for suicide risk and appropriate follow-up post-discharge among MDD-PE patients., Competing Interests: Declaration of competing interest QC, AE, JG, LF are employees of Janssen and may hold company stocks. PK was an employee of Janssen during the time the study was carried out. IB received consulting fees from Gedeon Richter and Janssen/ Janssen-Cilag; speaker's honoraria from Gedeon Richter, Hikma Pharmaceuticals, Janssen/Janssen-Cilag, KRKA, Lundbeck and Medichem Pharmaceuticals Inc. by Unilab; received research grant from Gedeon Richter; royalties from Oxford University Press. ZR received consulting fees from Janssen/Janssen-Cilag, received speaker's honoraria from Janssen/Janssen-Cilag, Servier and Krka, and served as an advisory board member for Lundbeck, Janssen/Janssen- Cilag, Servier and Krka. PD received consulting fees from Janssen/Janssen-Cilag. GS received consulting fees from Janssen/Janssen-Cilag and KRKA; speaker's honoraria from Janssen/Janssen-Cilag, Lundbeck, KRKA, Gedeon Richter, Mylan and Egis/Servier., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Major depressive disorder (MDD) is a leading cause of disability and premature mortality. This study compared the overall survival (OS) between patients with MDD and non-MDD controls stratified by gender, age, and comorbidities., Methods: This nationwide population-based cohort study utilized longitudinal patient data (01/01/2010 - 12/31/2020) from the Hungarian National Health Insurance Fund database, which contains healthcare service data for the Hungarian population. Patients with MDD were selected and matched 1:1 to those without MDD using exact matching. The rates of conversion from MDD to bipolar disorder (BD) or schizophrenia were also investigated., Results: Overall, 471,773 patients were included in each of the matched MDD and non-MDD groups. Patients with MDD had significantly worse OS than non-MDD controls (hazard ratio [HR] = 1.50; 95% CI: 1.48-1.51; males HR = 1.69, 95% CI: 1.66-1.72; females HR = 1.40, 95% CI: 1.38-1.42). The estimated life expectancy of patients with MDD was 7.8 and 6.0 years less than that of controls aged 20 and 45 years, respectively. Adjusted analyses based on the presence of baseline comorbidities also showed that patients with MDD had worse survival than non-MDD controls (adjusted HR = 1.29, 95% CI: 1.28-1.31). After 11 years of follow-up, the cumulative conversions from MDD to BD and schizophrenia were 6.8 and 3.4%, respectively. Converted patients had significantly worse OS than non-converted patients., Conclusions: Compared with the non-MDD controls, a higher mortality rate in patients with MDD, especially in those with comorbidities and/or who have converted to BD or schizophrenia, suggests that early detection and personalized treatment of MDD may reduce the mortality in patients diagnosed with MDD.

Background: Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory diseases associated with a substantial healthcare utilization., Aim: Our aim was to estimate the national prevalence of inflammatory bowel disease (IBD), CD and UC and to describe current drug treatment practices in CD and UC., Methods: Patients and drug dispensing events were identified according to international classification codes for UC and CD in in-patient care, non-primary out-patient care and drug prescription databases (2011-2013) of the National Health Insurance Fund., Results: A total of 55,039 individuals (men: 44.6%) with physician-diagnosed IBD were alive in Hungary in 2013, corresponding to a prevalence of 0.55% (95% CI, 0.55-0.56). The prevalence of CD 0.20% (95% CI, 0.19-0.20), and UC was 0.34% (95% CI, 0.33-0.34). The prevalence both in men and women was the highest in the 20-39 year-olds in CD. Current use of immunosuppressives and biological therapy was highest in the pediatric CD population (44% and 15%) followed by adult CD (33% and 9%), while their use was lowest in elderly patients. Interestingly, current use of 5-ASA (5-aminosalicylates) was high in both UC and CD irrespective of the age group., Conclusions: The Hungarian IBD prevalence based on nationwide database of the National Health Insurance Fund was high. We identified significant differences in the drug prescription practices according to age-groups., (Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)