The economic costs of neuroticism: A population-based study.

Context The importance of neuroticism for mental health care use and public health is well established. However, most research has focused on the association between neuroticism and a single specific disorder or health outcome, and the overall effect of neuroticism on use of somatic and mental health care and on society is not clear.

Objective To examine the economic costs of neuroticism to get an impression of the overall effect of neuroticism on mental health care and on society in general.

Design Cross-sectional population-based study.

Setting General population.

Participants A large representative sample (N = 5504) of the Dutch general population.

Main Outcome Measures The costs (health service uptake in primary and secondary mental health care, out-of-pocket costs, and production losses) associated with neuroticism.

Results The total per capita excess costs were $12 362 per year for the reference year 2007 in the 5% highest scorers of neuroticism, $8243 in the 10% highest scorers, and $5572 in the 25% highest scorers. The per capita excess costs of neuroticism are considerably higher than those of mental disorders. The total excess costs of neuroticism per 1 million inhabitants resulting from the 25% highest scorers ($1.393 billion) were approximately 2.5 times as high as the excess costs of common mental disorders ($585 million).

Conclusions The economic costs of neuroticism are enormous and exceed those of common mental disorders. We should start thinking about interventions that focus not on each of the specific negative outcomes of neuroticism but rather on the starting point itself.