Lu S, Zhang Y, Liu T, et al. - The economic impact of symptom clusters has been investigated.

• Using the Patient Health Questionnaire-9 and the Client Service Receipt Inventory, data were obtained from 3,255 older adults aged 60 years and over.

• Analyzing these data, depressive symptoms and service utilization were measured to determine 1-year care expenditure.

• Depressive symptoms were categorized into four clusters based on Research Domain Criteria framework: Negative Valance Systems and Externalizing [NVSE] (anhedonia and depression), Negative Valance Systems and Internalizing [NVSI] (guilt and self-harm), Arousal and Regulatory Systems [ARS] (sleep, fatigue, and appetite), and Cognitive and Sensorimotor Systems [CSS] (concentration and psychomotor).

• The largest economic impact on non-psychiatric care expenditure was recorded of core affective symptoms; a one-point rise in NVSE was linked with USD$ 571 additional non-psychiatric care expenditure.

• Overall, the findings emphasize the relevance of attaining insight into the economic impacts on care utilization based on symptom profiles with a particular emphasis on symptom combinations.

• Care allocation should be optimized on the basis of older adults' depressive symptom profiles rather than by simply considering their depression sum-score or the severity defined by cut-off points.