Cost-effectiveness of cognitive therapy as an early intervention for post-traumatic stress disorder in children and adolescents: a trial based evaluation and model / J. SHEARER in Journal of Child Psychology and Psychiatry, 59-7 (July 2018)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 59-7 (July 2018) . - p.773-780 Titre : Cost-effectiveness of cognitive therapy as an early intervention for post-traumatic stress disorder in children and adolescents: a trial based evaluation and model Type de document : Texte imprimé et/ou numérique Auteurs : J. SHEARER, Auteur ; N. PAPANIKOLAOU, Auteur ; R. MEISER-STEDMAN, Auteur ; A. MCKINNON, Auteur ; Tim DALGLEISH, Auteur ; P. SMITH, Auteur ; C. DIXON, Auteur ; Sarah BYFORD, Auteur Article en page(s) : p.773-780 Langues : Anglais (eng) Mots-clés : Economic evaluation  cognitive therapy  post-traumatic stress disorder Index. décimale : PER Périodiques Résumé : BACKGROUND: Untreated post-traumatic stress disorder (PTSD) in children and adolescents is associated with a considerable economic burden on the health system, families and society. Recent research has demonstrated the potential efficacy of cognitive therapy as an early intervention for PTSD in children and adolescents. Children who experienced a single traumatic event in the previous two to six months and were randomized to cognitive therapy for PTSD (CT-PTSD) were significantly more likely to be PTSD-free compared to those randomized to usual care represented by waitlist control. The current study evaluated the economic impact of improvements in the treatment of PTSD in children and adolescents. METHODS: A cost-effectiveness analysis was conducted from the national health service/personal social services perspective with outcomes expressed as quality-adjusted life years (QALYs). Patient level costs and outcomes were collected during the 11 week clinical trial and extrapolated to a three year time horizon using economic modelling methods. Uncertainty was estimated using probabilistic sensitivity analysis and assumptions were tested using one way sensitivity analysis. RESULTS: The incremental cost-effectiveness ratio at 3 years was pound2,205 per QALY with a 60%-69% probability of CT-PTSD being cost-effective compared to usual care at the UK pound20,000 to pound30,000 per QALY decision threshold. CONCLUSIONS: This study provides preliminary evidence for the cost-effectiveness of cognitive therapy in this treatment population. Larger pragmatic trials with longer follow-up are indicated. En ligne : http://dx.doi.org/10.1111/jcpp.12851 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=368 [article] Cost-effectiveness of cognitive therapy as an early intervention for post-traumatic stress disorder in children and adolescents: a trial based evaluation and model [Texte imprimé et/ou numérique] / J. SHEARER, Auteur ; N. PAPANIKOLAOU, Auteur ; R. MEISER-STEDMAN, Auteur ; A. MCKINNON, Auteur ; Tim DALGLEISH, Auteur ; P. SMITH, Auteur ; C. DIXON, Auteur ; Sarah BYFORD, Auteur . - p.773-780. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 59-7 (July 2018) . - p.773-780 Mots-clés : Economic evaluation  cognitive therapy  post-traumatic stress disorder Index. décimale : PER Périodiques Résumé : BACKGROUND: Untreated post-traumatic stress disorder (PTSD) in children and adolescents is associated with a considerable economic burden on the health system, families and society. Recent research has demonstrated the potential efficacy of cognitive therapy as an early intervention for PTSD in children and adolescents. Children who experienced a single traumatic event in the previous two to six months and were randomized to cognitive therapy for PTSD (CT-PTSD) were significantly more likely to be PTSD-free compared to those randomized to usual care represented by waitlist control. The current study evaluated the economic impact of improvements in the treatment of PTSD in children and adolescents. METHODS: A cost-effectiveness analysis was conducted from the national health service/personal social services perspective with outcomes expressed as quality-adjusted life years (QALYs). Patient level costs and outcomes were collected during the 11 week clinical trial and extrapolated to a three year time horizon using economic modelling methods. Uncertainty was estimated using probabilistic sensitivity analysis and assumptions were tested using one way sensitivity analysis. RESULTS: The incremental cost-effectiveness ratio at 3 years was pound2,205 per QALY with a 60%-69% probability of CT-PTSD being cost-effective compared to usual care at the UK pound20,000 to pound30,000 per QALY decision threshold. CONCLUSIONS: This study provides preliminary evidence for the cost-effectiveness of cognitive therapy in this treatment population. Larger pragmatic trials with longer follow-up are indicated. En ligne : http://dx.doi.org/10.1111/jcpp.12851 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=368

Ketogenic diet modifies the gut microbiota in a murine model of autism spectrum disorder / C. NEWELL in Molecular Autism, 7 (2016)  

Public ISBD [article]  inMolecular Autism > 7 (2016) . - 37p. Titre : Ketogenic diet modifies the gut microbiota in a murine model of autism spectrum disorder Type de document : Texte imprimé et/ou numérique Auteurs : C. NEWELL, Auteur ; M. R. BOMHOF, Auteur ; R. A. REIMER, Auteur ; D. S. HITTEL, Auteur ; J. M. RHO, Auteur ; J. SHEARER, Auteur Article en page(s) : 37p. Langues : Anglais (eng) Mots-clés : Animals  Autism Spectrum Disorder/microbiology  Bacteria/isolation & purification  Behavior, Animal  Cecum/microbiology  Diet, Ketogenic  Disease Models, Animal  Feces/microbiology  Gastrointestinal Microbiome  Male  Mice  Mice, Inbred C57BL  Social Behavior  Autism spectrum disorder  BTBR mouse  Gut microbiome  Ketogenic diet Index. décimale : PER Périodiques Résumé : BACKGROUND: Gastrointestinal dysfunction and gut microbial composition disturbances have been widely reported in autism spectrum disorder (ASD). This study examines whether gut microbiome disturbances are present in the BTBR(T + tf/j) (BTBR) mouse model of ASD and if the ketogenic diet, a diet previously shown to elicit therapeutic benefit in this mouse model, is capable of altering the profile. FINDINGS: Juvenile male C57BL/6 (B6) and BTBR mice were fed a standard chow (CH, 13 % kcal fat) or ketogenic diet (KD, 75 % kcal fat) for 10-14 days. Following diets, fecal and cecal samples were collected for analysis. Main findings are as follows: (1) gut microbiota compositions of cecal and fecal samples were altered in BTBR compared to control mice, indicating that this model may be of utility in understanding gut-brain interactions in ASD; (2) KD consumption caused an anti-microbial-like effect by significantly decreasing total host bacterial abundance in cecal and fecal matter; (3) specific to BTBR animals, the KD counteracted the common ASD phenotype of a low Firmicutes to Bacteroidetes ratio in both sample types; and (4) the KD reversed elevated Akkermansia muciniphila content in the cecal and fecal matter of BTBR animals. CONCLUSIONS: Results indicate that consumption of a KD likely triggers reductions in total gut microbial counts and compositional remodeling in the BTBR mouse. These findings may explain, in part, the ability of a KD to mitigate some of the neurological symptoms associated with ASD in an animal model. En ligne : http://dx.doi.org/10.1186/s13229-016-0099-3 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=328 [article] Ketogenic diet modifies the gut microbiota in a murine model of autism spectrum disorder [Texte imprimé et/ou numérique] / C. NEWELL, Auteur ; M. R. BOMHOF, Auteur ; R. A. REIMER, Auteur ; D. S. HITTEL, Auteur ; J. M. RHO, Auteur ; J. SHEARER, Auteur . - 37p. Langues : Anglais (eng) in Molecular Autism > 7 (2016) . - 37p. Mots-clés : Animals  Autism Spectrum Disorder/microbiology  Bacteria/isolation & purification  Behavior, Animal  Cecum/microbiology  Diet, Ketogenic  Disease Models, Animal  Feces/microbiology  Gastrointestinal Microbiome  Male  Mice  Mice, Inbred C57BL  Social Behavior  Autism spectrum disorder  BTBR mouse  Gut microbiome  Ketogenic diet Index. décimale : PER Périodiques Résumé : BACKGROUND: Gastrointestinal dysfunction and gut microbial composition disturbances have been widely reported in autism spectrum disorder (ASD). This study examines whether gut microbiome disturbances are present in the BTBR(T + tf/j) (BTBR) mouse model of ASD and if the ketogenic diet, a diet previously shown to elicit therapeutic benefit in this mouse model, is capable of altering the profile. FINDINGS: Juvenile male C57BL/6 (B6) and BTBR mice were fed a standard chow (CH, 13 % kcal fat) or ketogenic diet (KD, 75 % kcal fat) for 10-14 days. Following diets, fecal and cecal samples were collected for analysis. Main findings are as follows: (1) gut microbiota compositions of cecal and fecal samples were altered in BTBR compared to control mice, indicating that this model may be of utility in understanding gut-brain interactions in ASD; (2) KD consumption caused an anti-microbial-like effect by significantly decreasing total host bacterial abundance in cecal and fecal matter; (3) specific to BTBR animals, the KD counteracted the common ASD phenotype of a low Firmicutes to Bacteroidetes ratio in both sample types; and (4) the KD reversed elevated Akkermansia muciniphila content in the cecal and fecal matter of BTBR animals. CONCLUSIONS: Results indicate that consumption of a KD likely triggers reductions in total gut microbial counts and compositional remodeling in the BTBR mouse. These findings may explain, in part, the ability of a KD to mitigate some of the neurological symptoms associated with ASD in an animal model. En ligne : http://dx.doi.org/10.1186/s13229-016-0099-3 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=328

---

1 (1 - 2 / 2)