Cost-Effectiveness of Classroom-Based Cognitive Behaviour Therapy in Reducing Symptoms of Depression in Adolescents: A Trial-Based Analysis
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| Title: | Cost-Effectiveness of Classroom-Based Cognitive Behaviour Therapy in Reducing Symptoms of Depression in Adolescents: A Trial-Based Analysis |
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| Language: | English |
| Authors: | Anderson, Rob, Ukoumunne, Obioha C., Sayal, Kapil, Phillips, Rhiannon, Taylor, John A., Spears, Melissa, Araya, Ricardo, Lewis, Glyn, Millings, Abigail, Montgomery, Alan A., Stallard, Paul |
| Source: | Journal of Child Psychology and Psychiatry. Dec 2014 55(12):1390-1397. |
| Availability: | Wiley-Blackwell. 350 Main Street, Malden, MA 02148. Tel: 800-835-6770; Tel: 781-388-8598; Fax: 781-388-8232; e-mail: cs-journals@wiley.com; Web site: http://www.wiley.com/WileyCDA |
| Peer Reviewed: | Y |
| Page Count: | 8 |
| Publication Date: | 2014 |
| Document Type: | Journal Articles Reports - Research |
| Education Level: | Secondary Education |
| Descriptors: | Cost Effectiveness, Behavior Modification, Cognitive Restructuring, Depression (Psychology), Adolescents, Foreign Countries, Secondary School Students, Outcome Measures, Prevention, Secondary Schools, Comparative Analysis |
| Geographic Terms: | United Kingdom |
| DOI: | 10.1111/jcpp.12248 |
| ISSN: | 0021-9630 |
| Abstract: | Background: A substantial minority of adolescents suffer from depression and it is associated with increased risk of suicide, social and educational impairment, and mental health problems in adulthood. A recently conducted randomized controlled trial in England evaluated the effectiveness of a manualized universally delivered age-appropriate CBT programme in school classrooms. The cost-effectiveness of the programme for preventing low mood and depression for all participants from a health and social care sector perspective needs to be determined. Methods: A trial-based cost-effectiveness analysis based on a cluster-randomized controlled trial (trial registration--ISRCTN 19083628) comparing classroom-based CBT with usual school provision of Personal Social and Health Education. Per-student cost of intervention was estimated from programme records. The study was undertaken in eight mixed-sex UK secondary schools, and included 3,357 school children aged 12 to 16 years (in the two trial arms evaluated in the cost-effectiveness analysis). The main outcome measures were individual self-reported data on care costs, Quality-Adjusted Life-Years (QALYs, based on the EQ-5D health-related quality-of-life instrument) and symptoms of depression (Short Mood and Feelings Questionnaire) at baseline, 6 and 12 months. Results: Although there was lower quality-adjusted life-years over 12 months (-0.05 QALYs per person, 95% confidence interval -0.09 to -0.005, p = 0.03) with CBT, this is a "clinically" negligible difference, which was not found in the complete case analyses. There was little evidence of any between-arm differences in SMFQ scores (0.19, 95% CI -0.57 to 0.95, p = 0.62), or costs (£142, 95% CI -£132 to £415, p = 0.31) per person for CBT versus usual school provision. Conclusions: Our analysis suggests that the universal provision of classroom-based CBT is unlikely to be either more effective or less costly than usual school provision. |
| Abstractor: | As Provided |
| Entry Date: | 2014 |
| Accession Number: | EJ1045771 |
| Database: | ERIC |
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| Abstract: | Background: A substantial minority of adolescents suffer from depression and it is associated with increased risk of suicide, social and educational impairment, and mental health problems in adulthood. A recently conducted randomized controlled trial in England evaluated the effectiveness of a manualized universally delivered age-appropriate CBT programme in school classrooms. The cost-effectiveness of the programme for preventing low mood and depression for all participants from a health and social care sector perspective needs to be determined. Methods: A trial-based cost-effectiveness analysis based on a cluster-randomized controlled trial (trial registration--ISRCTN 19083628) comparing classroom-based CBT with usual school provision of Personal Social and Health Education. Per-student cost of intervention was estimated from programme records. The study was undertaken in eight mixed-sex UK secondary schools, and included 3,357 school children aged 12 to 16 years (in the two trial arms evaluated in the cost-effectiveness analysis). The main outcome measures were individual self-reported data on care costs, Quality-Adjusted Life-Years (QALYs, based on the EQ-5D health-related quality-of-life instrument) and symptoms of depression (Short Mood and Feelings Questionnaire) at baseline, 6 and 12 months. Results: Although there was lower quality-adjusted life-years over 12 months (-0.05 QALYs per person, 95% confidence interval -0.09 to -0.005, p = 0.03) with CBT, this is a "clinically" negligible difference, which was not found in the complete case analyses. There was little evidence of any between-arm differences in SMFQ scores (0.19, 95% CI -0.57 to 0.95, p = 0.62), or costs (£142, 95% CI -£132 to £415, p = 0.31) per person for CBT versus usual school provision. Conclusions: Our analysis suggests that the universal provision of classroom-based CBT is unlikely to be either more effective or less costly than usual school provision. |
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| ISSN: | 0021-9630 |
| DOI: | 10.1111/jcpp.12248 |
