title: A randomized controlled trial of the efficacy and cost-effectiveness of a brief intensified cognitive behavioral therapy and/or pharmacotherapy for mood and anxiety disorders: design and methods.
abstract: BACKGROUND
  Anxiety and mood disorders involve a high disease burden and are associated with high economic costs. A stepped-care approach intervention and abbreviated diagnostic method are assumed to increase effectiveness and efficiency of the mental healthcare and are expected to reduce economic costs.
  
  
  METHODS
  Presented are the rationale, design, and methods of a two-armed randomized controlled trial comparing 'treatment as usual' (TAU) with a brief intensified cognitive behavioral therapy (CBT) and/or pharmacotherapy. Eligible participants (N=500) of five Dutch outpatient Mental Healthcare Centers are randomly assigned to either TAU or to the experimental condition (brief CBT and/or pharmacotherapy). Data on patients' progress and clinical effectiveness of treatment are assessed at baseline, post-treatment (3 months after baseline), and at 6 and 12 months post-treatment by Routine Outcome Monitoring (ROM). Cost analysis is performed on the obtained data.
  
  
  CONCLUSIONS
  Since few studies have investigated both the clinical and cost effectiveness of a stepped-care approach intervention and a shortened diagnostic ROM method in both anxiety and/or mood disorders within secondary mental health care, the results of this study might contribute to the improvement of (cost)-effective treatment options and diagnostic methods for these disorders.
authors.affiliation: Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands. d.meuldijk@lumc.nl
authors.forename: Denise
authors.initials: D
authors.lastname: Meuldijk
authors.forename: Ingrid V E
authors.initials: IV
authors.lastname: Carlier
authors.forename: Irene M
authors.initials: IM
authors.lastname: van Vliet
authors.forename: M Elske
authors.initials: ME
authors.lastname: van den Akker-Marle
authors.forename: Frans G
authors.initials: FG
authors.lastname: Zitman
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000628:therapy*; D015337:Multicenter Studies as Topic / Q000379:methods; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D017367:Selective Serotonin Reuptake Inhibitors / Q000191:economics / Q000627:therapeutic use*; D016037:Single-Blind Method; D012959:Socioeconomic Factors
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors