Four-Year Cost-effectiveness of Cognitive Behavior Therapy for Preventing First-episode Psychosis: The Dutch Early Detection Intervention Evaluation (EDIE-NL) Trial.

Autor:	Ising HK; Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands., Lokkerbol J; Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.; Centre of Economic Evaluation, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands., Rietdijk J; Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands.; Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands., Dragt S; Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands., Klaassen RM; Child and Adolescent Department, University Medical Center, Utrecht, The Netherlands., Kraan T; Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands., Boonstra N; Department of Research and Education, Friesland Mental Health Services, Leeuwarden, The Netherlands., Nieman DH; Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands., van den Berg DP; Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands., Linszen DH; Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands., Wunderink L; Department of Research and Education, Friesland Mental Health Services, Leeuwarden, The Netherlands., Veling W; Department of Psychiatry, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands., Smit F; Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.; Department of Public Mental Health, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands., van der Gaag M; Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands.; Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	Schizophrenia bulletin [Schizophr Bull] 2017 Mar 01; Vol. 43 (2), pp. 365-374.
DOI:	10.1093/schbul/sbw084
Abstrakt:	Background: This study aims to evaluate the long-term cost-effectiveness of add-on cognitive behavior therapy (CBT) for the prevention of psychosis for individuals at ultrahigh risk (UHR) of psychosis. Method: The Dutch Early Detection and Intervention randomized controlled trial was used, comparing routine care (RC; n = 101) with routine care plus CBT for UHR (here called CBTuhr; n = 95). A cost-effectiveness analysis was conducted with treatment response (defined as proportion of averted transitions to psychosis) as an outcome and a cost-utility analysis with quality-adjusted life years (QALYs) gained as a secondary outcome. Results: The proportion of averted transitions to psychosis was significantly higher in the CBTuhr condition (with a risk difference of 0.122; b = 1.324, SEb = 0.017, z = 7.99, P < 0.001). CBTuhr showed an 83% probability of being more effective and less costly than RC by -US$ 5777 (savings) per participant. In addition, over the 4-year follow-up period, cumulative QALY health gains were marginally (but not significantly) higher in CBTuhr than for RC (2.63 vs. 2.46) and the CBTuhr intervention had a 75% probability of being the superior treatment (more QALY gains at lower costs) and a 92% probability of being cost-effective compared with RC at the Dutch threshold value (US$ 24 560; €20 000 per QALY). Conclusions: Add-on preventive CBTuhr had a high likelihood (83%) of resulting in more averted transitions to psychosis and lower costs as compared with RC. In addition, the intervention had a high likelihood (75%) of resulting in more QALY gains and lower costs as compared to RC. (© The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com)
Databáze:	MEDLINE
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