TY  - JOUR
PY  - 2019//
TI  - Cost-effectiveness of preventing depression among at-risk youths: postintervention and 2-year follow-up
JO  - Psychiatric services
A1  - Lynch, Frances L.
A1  - Dickerson, John F.
A1  - Clarke, Gregory N.
A1  - Beardslee, William R.
A1  - Weersing, V. Robin
A1  - Gladstone, Tracy R. G.
A1  - Porta, Giovanna
A1  - Brent, David A.
A1  - Mark, Tami L.
A1  - DeBar, Lynn L.
A1  - Hollon, Steven D.
A1  - Garber, Judy
SP  - 279
EP  - 286
VL  - 70
IS  - 4
N2  - 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. <br><br>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. <br><br>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. <br><br>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.<p />  <p>Language: en</p>
LA  - en
SN  - 1075-2730
UR  - http://dx.doi.org/10.1176/appi.ps.201800144
ID  - ref1
ER  -