Cost-effectiveness of preventing depression in primary care patients: randomised trial.
BACKGROUND
Little is known about the cost-effectiveness of preventing mental disorders.


OBJECTIVE
To study the cost-effectiveness of care as usual plus minimal contact psychotherapy relative to usual care alone in preventing depressive disorder.


METHODS
An economic evaluation was conducted alongside a randomised clinical trial. Primary care patients with sub-threshold depression were assigned to minimal contact psychotherapy plus usual care (n=107) or to usual care alone (n=109).


RESULTS
Primary care patients with sub-threshold depression benefited from minimal contact psychotherapy as it reduced the risk of developing a full-blown depressive disorder from 18% to 12%. In addition, this intervention had a 70% probability of being more cost-effective than usual care alone. A sensitivity analysis indicated the robustness of these results.


CONCLUSIONS
Over 1 year adjunctive minimal contact psychotherapy improved outcomes and generated lower costs. This intervention is therefore superior to usual care alone in terms of cost-effectiveness.
Department of Prevention and Early Intervention, Trimbos Institute, PO Box 725, 2500 AS Utrecht, The Netherlands. fsmit@trimbos.nl
Filip
F
Smit
Godelief
G
Willemse
Marc
M
Koopmanschap
Simone
S
Onrust
Pim
P
Cuijpers
Aartjan
A
Beekman
D000293:Adolescent; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D003866:Depressive Disorder / Q000191:economics / Q000517:prevention & control*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000191:economics