Cost-effectiveness of cognitive behaviour therapy versus talking and usual care for depressed older people in primary care

ObjectiveTo determine the clinical effectiveness of Cognitive Behaviour Therapy (CBT) delivered in primary care for older people with depression and evaluation of a talking control (TC).MethodsA single-blind, randomized, controlled trial with 4- and 10-month follow-up. 204 people, aged 65 years or more, with a Geriatric Mental State diagnosis of depression were recruited from primary care. The interventions were: treatment as usual (TAU), TAU plus TC, or TAU plus CBT. The TC and CBT were offered over 4 months. The TC was to control for common effects in therapy. The Beck Depression Inventory-II (BDI-II) was the main outcome. Subsidiary measures were the Beck Anxiety Inventory, Social Functioning Questionnaire, and Euroqol. Intention to treat analysis (ITT) and Compliance Average Causal Effect (CACE) analyses was employed. The Cognitive therapy scale (CTS) evaluated common and specific factors in therapy.ResultsA mean of 7 sessions of TC or CBT were delivered. ITT analysis found improvements of −3.07 (95% confidence interval [CI], −5.73 to −0.42) and −3.65 (95% CI, −6.18 to −1.12) in BDI-II scores in favour of CBT vs TAU and TC respectively. CACE analysis found a benefit of 0.4 points (95% CI, 0.01 to 0.72) per therapy session of CBT over TC. Ratings for CBT on the CTS were high (mean [SD], 54.2 [4.1]) and showed no difference for nonspecific, but significant differences for specific factors in therapy.ConclusionCBT is an effective treatment for depressed older people. Improvement appears to be associated with specific factors in CBT.

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Measuring Psychological Change during Cognitive Behaviour Therapy in Primary Care: A Polish Study Using ‘PSYCHLOPS’ (Psychological Outcome Profiles)

PLoS ONE ◽

10.1371/journal.pone.0027378 ◽

2011 ◽

Vol 6 (12) ◽

pp. e27378 ◽

Cited By ~ 11

Author(s):

Slawomir Czachowski ◽

Paul Seed ◽

Peter Schofield ◽

Mark Ashworth

Keyword(s):

Primary Care ◽

Cognitive Behaviour Therapy ◽

Behaviour Therapy ◽

Psychological Outcome ◽

Psychological Change ◽

Cognitive Behaviour ◽

Polish Study

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Effectiveness of Transdiagnostic Cognitive Behaviour Therapy for Anxiety and Depression in Adults: A Systematic Review and Meta-analysis

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465816000229 ◽

2016 ◽

Vol 44 (6) ◽

pp. 673-690 ◽

Cited By ~ 26

Author(s):

Philip Andersen ◽

Paul Toner ◽

Martin Bland ◽

Dean McMillan

Keyword(s):

Systematic Review ◽

Cost Effectiveness ◽

Cognitive Behaviour Therapy ◽

Meta Analysis ◽

Grey Literature ◽

Anxiety And Depression ◽

Behaviour Therapy ◽

Cognitive Behavioural ◽

Cognitive Behaviour ◽

Effectiveness Data

Background: Transdiagnostic Cognitive Behaviour Therapy (CBT) seeks to identify core cognitive-behavioural processes hypothesized to be important across a range of disorders and to develop a treatment that targets these. This contrasts with standard CBT approaches that are disorder-specific. Proponents of transdiagnostic CBT suggest that it may offer advantages over disorder-specific CBT, but little is known about the effectiveness of this approach. Aims: The review aimed to summarize trial-based clinical and cost-effectiveness data on transdiagnostic CBT for anxiety and depression. Method: A systematic review of electronic databases, including peer-reviewed and grey literature sources, was conducted (n = 1167 unique citations). Results: Eight trials were eligible for inclusion in the review. There was evidence of an effect for transdiagnostic CBT when compared to a control condition. There were no differences between transdiagnostic CBT and active treatments in two studies. We found no evidence of cost-effectiveness data. Conclusions: Quality assessment of the primary studies indicated a number of methodological concerns that may serve to inflate the observed effects of transdiagnostic approaches. Although there are positive signs of the value of transdiagnostic CBT, there is as yet insufficient evidence to recommend its use in place of disorder-specific CBT.

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Cost-effectiveness of internet-delivered cognitive behaviour therapy for body dysmorphic disorder: results from a randomised controlled trial

10.1101/2021.08.23.21262455 ◽

2021 ◽

Author(s):

Oskar Flygare ◽

Erik Andersson ◽

Gjermund Glimsdal ◽

David Mataix-Cols ◽

Diana Djurfeldt ◽

...

Keyword(s):

Cost Effectiveness ◽

Outcome Measures ◽

Cognitive Behaviour Therapy ◽

Body Dysmorphic Disorder ◽

Controlled Trial ◽

Cost Utility ◽

Secondary Outcome ◽

Behaviour Therapy ◽

Supportive Psychotherapy ◽

Cognitive Behaviour

Objectives: To evaluate the cost-effectiveness of internet-delivered cognitive behaviour therapy for body dysmorphic disorder (BDD-NET). Design: Secondary cost-effectiveness analysis from a randomised controlled trial on BDD-NET versus online supportive psychotherapy. Setting: Academic medical centre. Participants: Self-referred adult patients with a primary diagnosis of body dysmorphic disorder and a score of 20 or higher on the modified Yale-Brown obsessive compulsive scale (n = 94). Patients receiving concurrent psychotropic drug treatment were included if the dose had been stable for at least two months and remained unchanged during the trial. Interventions: Participants received either BDD-NET (n = 47) or online supportive psychotherapy (n = 47) for 12 weeks. Primary and secondary outcome measures: The primary outcome measures were cost-effectiveness and cost-utility from a societal perspective, using remission status from a diagnostic interview and quality-adjusted life years from EQ-5D, respectively. Secondary outcome measures were cost-effectiveness and cost-utility from a health care perspective and the clinics perspective. Results: Compared to supportive psychotherapy, BDD-NET produced one additional remission for an average societal cost of $4132. The cost-utility analysis showed that BDD-NET generated one additional QALY to an average cost of $14319 from a societal perspective. Conclusions: BDD-NET is a cost-effective treatment for body dysmorphic disorder, compared to online supportive psychotherapy. The efficacy and cost-effectiveness of BDD-NET should be directly compared to face-to-face cognitive behaviour therapy.

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