Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Apr 30:12:22.
doi: 10.1186/s13034-018-0227-2. eCollection 2018.

Cost-effectiveness of dialectical behaviour therapy vs. enhanced usual care in the treatment of adolescents with self-harm

Egil Haga  1 , Eline Aas  2 , Berit Grøholt  1 , Anita J Tørmoen  1 , Lars Mehlum  1
Affiliations

Cost-effectiveness of dialectical behaviour therapy vs. enhanced usual care in the treatment of adolescents with self-harm

Egil Haga et al. Child Adolesc Psychiatry Ment Health. .

Abstract

Background: Studies have shown that dialectical behaviour therapy (DBT) is effective in reducing self-harm in adults and adolescents.

Aims: To evaluate the cost-effectiveness of DBT for adolescents (DBT-A) compared to enhanced usual care (EUC).

Methods: In a randomised study, 77 adolescents with repeated self-harm were allocated to 19 weeks of outpatient treatment, either DBT-A (n = 39) or EUC (n = 38). Cost-effective analyses, including estimation of incremental cost-effectiveness ratios, were conducted with self-harm and global functioning (CGAS) as health outcomes.

Results: Using self-harm as effect outcome measure, the probability of DBT being cost-effective compared to EUC increased with increasing willingness to pay up to a ceiling of 99.5% (threshold of € 1400), while with CGAS as effect outcome measure, this ceiling was 94.9% (threshold of € 1600).

Conclusions: Given the data, DBT-A had a high probability of being a cost-effective treatment.

Keywords: Cost-effectiveness; Longitudinal; Psychotherapy; Randomised trial; Self-harm.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
The figure shows plots of simulated ICERs, mean incremental costs on the y-axis, and mean incremental effect on the x-axis (per bootstrap sample, 1000 replications), on the left hand side. On the right hand side, the corresponding CEACs show changes in probability of DBT-A being cost-effective compared to EUC (y-axis) as a function of increasing threshold values (x-axis). a Plot of simulated ICERs and CEAC with incremental total treatment costs and mean incremental effect in terms of mean number of self-harm episodes. Note that increased effect is indicated by negative values on the x-axis. b Plot of simulated ICERs and CEAC with incremental outpatient costs (emergency treatment costs excluded) and mean incremental effect in terms of mean number of self-harm episodes. Note that increased effect is indicated by negative values on the x-axis. c Plot of simulated ICERs and CEAC with incremental total treatment costs and mean incremental effect in terms of change in global functioning (CGAS)
See this image and copyright information in PMC

References

    1. Nock M. Self-injury. Annu Rev Clin Psychol. 2010;6:339–363. doi: 10.1146/annurev.clinpsy.121208.131258. - DOI - PubMed
    1. Jacobson C, Muehlenkamp J, Miller A, Blake Turner J. Psychiatric impariment among adolescents engaging in different types of deliberate self-harm. J Clin Child Adolesc Psychol. 2008;37(2):363–375. doi: 10.1080/15374410801955771. - DOI - PubMed
    1. Nock M, Green J, Hwang I, McLaughlin K, Sampson N, Zaslavsky A, Kessler R. Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents. JAMA Psychiatry. 2013;70(3):300–310. doi: 10.1001/2013.jamapsychiatry.55. - DOI - PMC - PubMed
    1. Nixon M, Cloutier P, Jansson S. Nonsuicidal self-harm in youth: a population-based survey. CMAJ. 2008;178(3):306–312. doi: 10.1503/cmaj.061693. - DOI - PMC - PubMed
    1. Tørmoen A, Rossow I, Mork E, Mehlum L. Contact with child and adolescent psychiatric services among self-harming and suicidal adolescents in the general population: a cross sectional study. Child Adolesc Psychiatry Ment Health. 2014;8:13. doi: 10.1186/1753-2000-8-13. - DOI - PMC - PubMed

LinkOut - more resources