[article]
| Titre : |
Cost-effectiveness of classroom-based cognitive behaviour therapy in reducing symptoms of depression in adolescents: a trial-based analysis |
| Type de document : |
Texte imprimé et/ou numérique |
| Auteurs : |
Rob ANDERSON, Auteur ; Obioha C. UKOUMUNNE, Auteur ; Kapil SAYAL, Auteur ; Rhiannon PHILLIPS, Auteur ; John A. TAYLOR, Auteur ; Melissa SPEARS, Auteur ; Ricardo ARAYA, Auteur ; Glyn LEWIS, Auteur ; Abigail MILLINGS, Auteur ; Alan A. MONTGOMERY, Auteur ; Paul STALLARD, Auteur |
| Article en page(s) : |
p.1390-1397 |
| Langues : |
Anglais (eng) |
| Mots-clés : |
Depression prevention schools CBT cognitive behavioural therapy cost-effectiveness adolescents |
| Index. décimale : |
PER Périodiques |
| Résumé : |
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 (?.05 QALYs per person, 95% confidence interval ?.09 to ?.005, p = .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 = .62), or costs (£142, 95% CI ?£132 to £415, p = .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. |
| En ligne : |
http://dx.doi.org/10.1111/jcpp.12248 |
| Permalink : |
https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=243 |
in Journal of Child Psychology and Psychiatry > 55-12 (December 2014) . - p.1390-1397
[article] Cost-effectiveness of classroom-based cognitive behaviour therapy in reducing symptoms of depression in adolescents: a trial-based analysis [Texte imprimé et/ou numérique] / Rob ANDERSON, Auteur ; Obioha C. UKOUMUNNE, Auteur ; Kapil SAYAL, Auteur ; Rhiannon PHILLIPS, Auteur ; John A. TAYLOR, Auteur ; Melissa SPEARS, Auteur ; Ricardo ARAYA, Auteur ; Glyn LEWIS, Auteur ; Abigail MILLINGS, Auteur ; Alan A. MONTGOMERY, Auteur ; Paul STALLARD, Auteur . - p.1390-1397. Langues : Anglais ( eng) in Journal of Child Psychology and Psychiatry > 55-12 (December 2014) . - p.1390-1397
| Mots-clés : |
Depression prevention schools CBT cognitive behavioural therapy cost-effectiveness adolescents |
| Index. décimale : |
PER Périodiques |
| Résumé : |
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 (?.05 QALYs per person, 95% confidence interval ?.09 to ?.005, p = .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 = .62), or costs (£142, 95% CI ?£132 to £415, p = .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. |
| En ligne : |
http://dx.doi.org/10.1111/jcpp.12248 |
| Permalink : |
https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=243 |
|
Cost-effectiveness of classroom-based cognitive behaviour therapy in reducing symptoms of depression in adolescents: a trial-based analysis in Journal of Child Psychology and Psychiatry, 55-12 (December 2014)
