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The British Journal of Psychiatry (2005) 186: 500-506
© 2005 The Royal College of Psychiatrists

Cost-effectiveness of relapse-prevention cognitive therapy for bipolar disorder: 30-month study

DOMINIC H. LAM, PhD

Psychology Department, Institute of Psychiatry, London

PAUL McCRONE, PhD

Centre for the Economics of Mental Health, Health Services Research Department, Institute of Psychiatry, London

KIM WRIGHT, BA

Psychology Department, Institute of Psychiatry, London

NATALIE KERR, MSc

Psychological Medicine, Institute of Psychiatry, London

Correspondence: Dr Dominic H. Lam, Psychology Department, Institute of Psychiatry, DeCrespigny Park, London SE5 8AF. E-mail: D.Lam{at}iop.kcl.ac.uk

Declaration of interest None.

Background We have reported the advantageous clinical outcome of adding cognitive therapy to medication in the prevention of relapse of bipolar disorder.

Aims This 30-month study compares the cost-effectiveness of cognitive therapy with standard care.

Method We randomly allocated 103 individuals with bipolar 1 disorder to standard treatment and cognitive therapy plus standard treatment. Service use and costs were measured at 3-month intervals and cost-effectiveness was assessed using the net-benefit approach.

Results The group receiving cognitive therapy had significantly better clinical outcomes. The extra costs were offset by reduced service use elsewhere. The probability of cognitive therapy being cost-effective was high and robust to different therapy prices.

Conclusions Combination of cognitive therapy and mood stabilisers was superior to mood stabilisers alone in terms of clinical outcome and cost-effectiveness for those with frequent relapses of bipolar disorder.




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