Anderson, Rob, Ukoumunne, Obioha C., Sayal, Kapil, Phillips, Rhiannon, Taylor, John A., Spears, Melissa, Araya, Ricardo, Lewis, Glyn, Montgomery, Alan A. and Stallard, Paul
(2014)
Cost-effectiveness of classroom-based cognitive behaviour therapy in reducing symptoms of depression in adolescents: a trial-based analysis.
Journal of Child Psychology and Psychiatry, 55
(12).
pp. 1390-1397.
ISSN 1469-7610
Full text not available from this repository.
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 (−.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.
| Item Type: |
Article
|
| RIS ID: |
https://nottingham-repository.worktribe.com/output/993347 |
| Additional Information: |
This is the peer reviewed version of the following article: Anderson, R., Ukoumunne, O. C., Sayal, K., Phillips, R., Taylor, J. A., Spears, M., Araya, R., Lewis, G., Millings, A., Montgomery, A. A. and Stallard, P. (2014), Cost-effectiveness of classroom-based cognitive behaviour therapy in reducing symptoms of depression in adolescents: a trial-based analysis. J Child Psychol Psychiatr, 55: 1390–1397, which has been published in final form at http://dx.doi.org/10.1111/jcpp.12248. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. |
| Keywords: |
Depression prevention; schools; CBT ; cognitive behavioural therapy; cost-effectiveness; adolescents |
| Schools/Departments: |
University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Units > Clinical Trials Unit |
| Identification Number: |
https://doi.org/10.1111/jcpp.12248 |
| Depositing User: |
Daunt, Wendy
|
| Date Deposited: |
19 Sep 2017 13:21 |
| Last Modified: |
04 May 2020 20:12 |
| URI: |
https://eprints.nottingham.ac.uk/id/eprint/46510 |
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