%0 Journal Article %T Cost-effectiveness of preventing depression among at-risk youths: postintervention and 2-year follow-up %J Psychiatric services %D 2019 %A Lynch, Frances L. %A Dickerson, John F. %A Clarke, Gregory N. %A Beardslee, William R. %A Weersing, V. Robin %A Gladstone, Tracy R. G. %A Porta, Giovanna %A Brent, David A. %A Mark, Tami L. %A DeBar, Lynn L. %A Hollon, Steven D. %A Garber, Judy %V 70 %N 4 %P 279-286 %X OBJECTIVE:: Youth depression can be prevented, yet few programs are offered. Decision makers lack cost information. This study evaluated the cost-effectiveness of a cognitive-behavioral prevention program (CBP) versus usual care.

METHODS:: A cost-effectiveness analysis was conducted with data from a randomized controlled trial of 316 youths, ages 13-17, randomly assigned to CBP or usual care. Youths were at risk of depression because of a prior depressive disorder or subthreshold depressive symptoms, or both, and had parents with a prior or current depressive disorder. Outcomes included depression-free days (DFDs), quality-adjusted life years (QALYs), and costs.

RESULTS:: Nine months after baseline assessment, youths in CBP experienced 12 more DFDs (p=.020) and.018 more QALYs (p=.007), compared with youths in usual care, with an incremental cost-effectiveness ratio (ICER) of $24,558 per QALY. For youths whose parents were not depressed at baseline, CBP youths had 26 more DFDs (p=.001), compared with those in usual care (ICER=$10,498 per QALY). At 33 months postbaseline, youths in CBP had 40 more DFDs (p=.05) (ICER=$12,787 per QALY). At 33 months, CBP youths whose parents were not depressed at baseline had 91 more DFDs (p=.001) (ICER=$13,620 per QALY). For youths with a currently depressed parent at baseline, CBP was not significantly more effective than usual care at either 9 or 33 months, and costs were higher.

CONCLUSIONS:: CBP produced significantly better outcomes than usual care and was particularly cost-effective for youths whose parents were not depressed at baseline. Depression prevention programs could improve youths' health at a reasonable cost; services to treat depressed parents may also be warranted.

Language: en

%G en %I American Psychiatric Association %@ 1075-2730 %U http://dx.doi.org/10.1176/appi.ps.201800144