• Quote of the Day
    "Don't let what you can't do interfere with what you can do."
    John Wooden, posted by David Baxter

David Baxter

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Additional Psychotherapy Reduces Depression Risk By A Third

Additional psychotherapy involving minimal contact with a therapist reduces the risk of developing a full-blown depression by 30% in primary care patients with 'sub-threshold' depression, compared with care as usual, a new study from The Netherlands has found.

After one year, the incidence rate of depression in the group receiving additional therapy was 11.9%, compared with 18.3% in the group receiving usual care only - a reduction of one third.
Sub-threshold depression was defined as having at least one 'core symptom' of depression, plus one, two or three current depressive symptoms.

The aim of the one-year study, published in the April issue of the British Journal of Psychiatry, was to was to compare the cost-effectiveness of care as usual plus minimal contact psychotherapy, and usual care alone, in preventing depressive disorder.

The researchers conducted an economic evaluation alongside a randomized clinical trial. 107 primary care patients with sub-threshold depression were given minimal contact psychotherapy plus usual care, and 109 received usual care alone.

The additional therapy took the form of cognitive behavioral minimal contact psychotherapy. The main component was a self-help manual with instructions on mood management.

The self-help therapy was guided by six short telephone calls with a prevention worker. The control intervention was care as routinely provided by the general practitioners.

The economic evaluation took into account the costs of all types of health services, as well as the costs that stem from production losses through absenteeism and reduced efficiency at work while feeling ill.

66% of the participants in the study were female, 78% were living with a partner and 83% were employed.

After one year, the incidence rate of depression in the group receiving additional therapy was 11.9%, compared with 18.3% in the group receiving usual care only - a reduction of one third.

Overall, the average annual per capita total cost in the intervention group was 6766 euros, which compared favorably with 8614 euros in the usual care group. If patients were willing to pay for additional therapy to avoid an episode of depression, the cost-effectiveness of the intervention would increase.

The researchers comment that even the best evidence-based care as usual in the community can avert depression for only about a quarter of patients. This suggests that prevention may have to play a more important role in public mental health.

This study showed that there is a 70% probability that minimal contact psychotherapy as an addition to usual care is more cost-effective that usual care alone in preventing full-blown depression.

It is in line with other studies that have found that psychological interventions based on cognitive behavioral therapy (CBT) are cost-effective in primary care patients with depression. CBT also appears to be cost-effective for relapse prevention in chronic depression.

Two issues need more exploration. First, we need to know more about the cost-effectiveness of CBT in the long run.

Second, the intervention used in this study should perhaps be adapted for use over the internet. This could help to reduce the costs of providing the therapy, and at the same time promote its use by a larger segment of the population.

Smit F, Willemse G, Koopmanschap M, Onrust S, Cuijpers P and Aartjan Beekman A
Cost effectiveness of preventing depression in primary care patients: randomised trial
Br J Psychiatry, 188, 330-336 [Abstract]
 

foghlaim

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I like this article... very interesting..

i'd like to see the results of the two issues... cost of cbt in the long run, and what method they are thinking of.. when refferring to the internet adaptation.
 

David Baxter

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I think what that means is kind of an extension of this forum - advice delivered via some sort of internet interaction instead of face to face.
 

foghlaim

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that's what i was thinking.... i mean it already happens on here...( hmmm, maybe u could talk to them and inform them.) . it works and its free!!! well for a lot of ppl anyway.. don't u thnk??


*s*
 

David Baxter

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Yes, I do. It's not better than therapy and it's not really a substitute for therapy but it is a kind of crisis intervention and supportive therapy and I think it does help, especially for people who have limited alternatives.
 

foghlaim

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and I think it does help,
Hey David... don't just think it... believe it!!? ?


oops sorry.. look who i'm talking to..lol? ?the dr himself!

but u know what i? mean eh?

*s*
 

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