Martin, S.Zajac, I.Vincent, A.Adams, R.J.Appleton, S.Wittert, G.A.2023-07-172023-07-172021BMJ Open, 2021; 11(3):e044893-1-e044893-102044-60552044-6055https://hdl.handle.net/2440/138930OBJECTIVES: To examine the relationship between depression burden, health service utilisation and depression diagnosis in community-based men. DESIGN: Prospective cohort study. SETTING: Community-based. PARTICIPANTS: Men aged 35-80 years at recruitment (2002-2005), randomly selected from the northern and western suburbs of Adelaide, Australia, without depression at baseline, who attended follow-up visits (2007-2010) (n=1464). PRIMARY AND SECONDARY OUTCOME MEASURES: Depression symptoms were categorised into high burden (total score of ≥13 for the Beck Depression Inventory (BDI) or ≥10 for the Centre for Epidemiologic Studies Depression Scale (CES-D) or low burden (<13 for the BDI or <10 for the CES-D). Diagnosed depression was determined by patient-reported physician diagnosis. Frequent general practitioner (GP) visits were those occurring 5+ times over the preceding year. Use of national medical and prescription services (Medicare Benefit Schedule and Pharmaceutical Benefit Scheme; MBS and PBS) was assessed through data linkage. RESULTS: Frequent attendance and depression diagnosis was more common in men with a high than low burden of depression symptoms (45.9% vs 29.3%-18.7% vs 1.9%, p<0.001). Depression diagnoses were also more common in frequent GP attenders compared with low-average attenders (5.1% vs 2.2%, p<0.001). Among men with high burden of symptoms, there was no age-adjusted or multi-adjusted difference for likelihood of depression diagnosis between non-regular and frequent GP attenders. Annualised MBS and PBS expenditure was highest for men with undiagnosed depression. CONCLUSIONS: Men with a high burden of depression symptoms have commensurate use of health services when compared with those with a low burden, but only half report a physician diagnosis of depression. Undiagnosed depression led to a higher usage of medical and prescription services.en© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.depression & mood disordersepidemiologyprimary carepublic healthHumansProspective StudiesDepressionAdultAgedAged, 80 and overMiddle AgedHealth ServicesNational Health ProgramsAustraliaMaleJournal article10.1136/bmjopen-2020-0448932023-07-17570912Zajac, I. [0000-0002-7786-3993]Vincent, A. [0000-0002-6428-1070]Adams, R.J. [0000-0002-7572-0796]Appleton, S. [0000-0001-7292-9714]Wittert, G.A. [0000-0001-6818-6065]