Cost-effectiveness of classroom-based cognitive behaviour therapy in reducing symptoms of depression in adolescents: a trial-based analysis
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 man...
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| Format: | Article |
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Wiley
2014
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| Online Access: | https://eprints.nottingham.ac.uk/46510/ |
| _version_ | 1848797343985434624 |
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| author | Anderson, Rob Ukoumunne, Obioha C. Sayal, Kapil Phillips, Rhiannon Taylor, John A. Spears, Melissa Araya, Ricardo Lewis, Glyn Montgomery, Alan A. Stallard, Paul |
| author_facet | Anderson, Rob Ukoumunne, Obioha C. Sayal, Kapil Phillips, Rhiannon Taylor, John A. Spears, Melissa Araya, Ricardo Lewis, Glyn Montgomery, Alan A. Stallard, Paul |
| author_sort | Anderson, Rob |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T20:02:23Z |
| format | Article |
| id | nottingham-46510 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T20:02:23Z |
| publishDate | 2014 |
| publisher | Wiley |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-465102020-05-04T20:12:14Z https://eprints.nottingham.ac.uk/46510/ Cost-effectiveness of classroom-based cognitive behaviour therapy in reducing symptoms of depression in adolescents: a trial-based analysis Anderson, Rob Ukoumunne, Obioha C. Sayal, Kapil Phillips, Rhiannon Taylor, John A. Spears, Melissa Araya, Ricardo Lewis, Glyn Montgomery, Alan A. Stallard, Paul 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. Wiley 2014-12 Article NonPeerReviewed 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 Depression prevention; schools; CBT ; cognitive behavioural therapy; cost-effectiveness; adolescents http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12248/abstract doi:10.1111/jcpp.12248 doi:10.1111/jcpp.12248 |
| spellingShingle | Depression prevention; schools; CBT ; cognitive behavioural therapy; cost-effectiveness; adolescents Anderson, Rob Ukoumunne, Obioha C. Sayal, Kapil Phillips, Rhiannon Taylor, John A. Spears, Melissa Araya, Ricardo Lewis, Glyn Montgomery, Alan A. Stallard, Paul Cost-effectiveness of classroom-based cognitive behaviour therapy in reducing symptoms of depression in adolescents: a trial-based analysis |
| title | Cost-effectiveness of classroom-based cognitive behaviour therapy in reducing symptoms of depression in adolescents: a trial-based analysis |
| title_full | Cost-effectiveness of classroom-based cognitive behaviour therapy in reducing symptoms of depression in adolescents: a trial-based analysis |
| title_fullStr | Cost-effectiveness of classroom-based cognitive behaviour therapy in reducing symptoms of depression in adolescents: a trial-based analysis |
| title_full_unstemmed | Cost-effectiveness of classroom-based cognitive behaviour therapy in reducing symptoms of depression in adolescents: a trial-based analysis |
| title_short | Cost-effectiveness of classroom-based cognitive behaviour therapy in reducing symptoms of depression in adolescents: a trial-based analysis |
| title_sort | cost-effectiveness of classroom-based cognitive behaviour therapy in reducing symptoms of depression in adolescents: a trial-based analysis |
| topic | Depression prevention; schools; CBT ; cognitive behavioural therapy; cost-effectiveness; adolescents |
| url | https://eprints.nottingham.ac.uk/46510/ https://eprints.nottingham.ac.uk/46510/ https://eprints.nottingham.ac.uk/46510/ |