Evidence map›Paper›PMID 41213830›Full record

ArticleBMJ paediatrics open2025

Healthcare, caregiver and human capital costs associated with anxiety and depression among Indonesian youths.

Karen Arulsamy, Elmeida Effendy, Sarah Mardhiyah, Mustafa M Amin, M Surya Husada, Vita Camellia, Anne-Claire Stona, Eric Andrew Finkelstein

Abstract read
In one paragraph

Article in BMJ paediatrics open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Karen ArulsamyDuke-NUS Medical School, Singapore karen.arulsamy@duke-nus.edu.sg.ORCID http://orcid.org/0000-0002-6135-1598
Elmeida EffendyUniversitas Sumatera Utara, Medan, North Sumatra, Indonesia.
Sarah MardhiyahUniversitas Sumatera Utara, Medan, North Sumatra, Indonesia.
Mustafa M AminUniversitas Sumatera Utara, Medan, North Sumatra, Indonesia.
M Surya HusadaUniversitas Sumatera Utara, Medan, North Sumatra, Indonesia.
Vita CamelliaUniversitas Sumatera Utara, Medan, North Sumatra, Indonesia.
Anne-Claire StonaDuke-NUS Medical School, Singapore.
Eric Andrew FinkelsteinDuke-NUS Medical School, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn Indonesia, at least 5% of youths aged 10-17 report having a diagnosed mental health condition. Despite evidence from other countries showing substantial economic costs associated with youth mental health conditions, data on their broader economic impact in Indonesia remain limited. This study estimates the economic costs of anxiety and depression among Indonesian youths aged 10-17.

methodsThis study employs a low-cost web panel approach to estimate economic costs, providing a replicable model for countries lacking data. We administered a cross-sectional online survey to 3038 Indonesian citizens (adult proxies) aged at least 18 years via a web panel. Respondents filled out the Patient Health Questionnaire-4 (PHQ-4) on behalf of youths in their household to capture prevalence rates, resulting in data on 4328 youths. Proxies of youths who screened positive for anxiety and/or depression symptoms based on the PHQ-4 (N=174) were then asked about mental healthcare utilisation (medication use, outpatient visits, and ED visits and hospitalisations), days missed from work by caregivers to provide care, and days missed from school and reductions in productivity resulting from mental health symptoms. Healthcare utilisation and caregiver costs were monetised and extrapolated based on unit costs/average wages, prevalence rates within the sample and national youth population counts.

results10.6% reported symptoms consistent with anxiety and/or depression, yet 68.9% were never formally diagnosed, indicating a substantial diagnosis gap. Direct healthcare costs averaged IDR1 319 872 (US$83.15) per youth. Lost productivity of caregivers due to missing work to take care of these youths averaged IDR7 510 576 (US$473.17) per youth. These costs generate total annual medical costs of IDR5577.54 billion (US$0.35 billion) and total caregiver costs of IDR27 771.06 billion (US$1.75 billion). Overall, the total annual economic burden is IDR33 348.60 billion (US$2.1 billion). Youths with these symptoms also missed 187.1 hours of school per year and experienced a 45% decline in school performance.

conclusionsEvidence-based interventions should be adopted to address the significant health and economic burden associated with these symptoms.

Indexed as

AnxietyCaregiversCost of IllnessDepressionHealth Care CostsAdolescentChildCross-Sectional StudiesFemaleHumansIndonesiaMalePrevalenceAdolescent HealthChild HealthHealth PolicyLow and Middle Income Countries

Identifiers

PMID41213830
PMCPMC12603739

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.