A total of 4,946,852 patients met study criteria, and 14.2% (N=701,659) had a depression diagnosis during FY 2006. In FY 2007, a total of 167,069 (3.4%) patients died. Table 1 shows the characteristics of the study population. Leading causes of death for all patients included heart disease (N=45,110, 27%), malignant neoplasms (N=44,179, 27%), respiratory disease (N=11,713, 7%), cerebrovascular disease (N=7,197, 4%), accidents (N=5,730, 3%), diabetes (N=5,598, 3%), nephritis (N=3,671, 2%), septicemia (N=2,389, 1%) influenza (N=3,400, 2%), suicide (N=1,684, 1%), liver disease (N=2,106, 1%), and homicide (N=318, <1%). These causes of death represented 81% of all deaths among the entire patient population.
Table 2 illustrates age of death and YPLL for VA patients with or without depression. The mean±SD age of death was 71.1±13.0 and 75.9±10.9, respectively, for patients with or without depression. Death from all causes was associated with YPLL of 13.4±9.0 and 10.2±7.2, respectively, for patients with or without depression. Depression was associated with significantly earlier ages of death and more YPLL for all causes of death examined. Most deaths from unnatural causes (homicide, suicide, and accidents) occurred at earlier ages than deaths from natural causes; however, liver disease was also associated with earlier mortality. Unnatural deaths also accounted for the greatest differentials in YPLL and age of death between patients with or without depression.
Results from sensitivity analyses (data not shown) indicated that individuals with depression and any additional comorbid psychiatric disorder (anxiety disorder, bipolar disorder, posttraumatic stress disorder, or schizophrenia) had more YPLL and an earlier age of death than those without any psychiatric disorder. Further, those with any of the other disorders besides depression had more YPLL and died at an earlier age than patients with depression but not any of the other disorders. Finally, among people with no other comorbid psychiatric condition, people with depression died earlier and had more YPLL than those without depression.