HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS Psychiatric Bulletin Advances in Psychiatric Treatment All RCPsych Journals		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Related articles in BJP Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Byford, S. Articles by Goodyer, I. Search for Related Content PubMed PubMed Citation Articles by Byford, S. Articles by Goodyer, I.

Cost-effectiveness of selective serotonin reuptake inhibitors and routine specialist care with and without cognitive–behavioural therapy in adolescents with major depression

King's College London, Centre for the Economics of Mental Health, Institute of Psychiatry, London;

C. Roberts, PhD

Biostatistics Group, Division of Epidemiology and Health Sciences, University of Manchester, Manchester

P. Wilkinson, MD

Developmental Psychiatry Section, Department of Psychiatry, University of Cambridge, Cambridge

B. Dubicka, MRCPsych

Department of Child and Adolescent Psychiatry, Royal Manchester Children's Hospital, Manchester

R. G. Kelvin, MRCPsych

Cambridge Specialist Child and Adolescent Mental Health Service, Brookside Clinic, Cambridge

L. White, BA

Department of Child and Adolescent Psychiatry, Royal Manchester Children's Hospital, Manchester

C. Ford, CPsychol

Developmental Psychiatry Section, Department of Psychiatry, University of Cambridge, Cambridge

S. Breen, MA

Department of Child and Adolescent Psychiatry, Royal Manchester Children's Hospital, Manchester

I. Goodyer, FRCPsych

Developmental Psychiatry Section, Department of Psychiatry, University of Cambridge, Cambridge, UK

Correspondence: Sarah Byford, King's College London, Centre for the Economics of Mental Health, Box P024, Institute of Psychiatry, De Crespigny Park, London, SE5 8AF, UK. Tel: 020 7848 01988; fax: 020 7701 7600; email: s.byford{at}iop.kcl.ac.uk

Declaration of interest None.

Funding detailed in Acknowledgements.

Background Major depression is an important and costly problem among adolescents, yet evidence to support the provision of cost-effective treatments is lacking.

Aims To assess the short-term cost-effectiveness of combined selective serotonin reuptake inhibitors (SSRIs) and cognitive–behavioural therapy (CBT) together with clinical care compared with SSRIs and clinical care alone in adolescents with major depression.

Method Pragmatic randomised controlled trial in the UK. Outcomes and costs were assessed at baseline, 12 and 28 weeks.

Results The trial comprised 208 adolescents, aged 11-17 years, with major or probable major depression who had not responded to a brief initial psychosocial intervention. There were no significant differences in outcome between the groups with and without CBT. Costs were higher in the group with CBT, although not significantly so (P=0.057). Cost-effectiveness analysis and exploration of the associated uncertainty suggest there is less than a 30% probability that CBT plus SSRIs is more cost-effective than SSRIs alone.

Conclusions A combination of CBT plus SSRIs is not more cost-effective in the short-term than SSRIs alone for treating adolescents with major depression in receipt of routine specialist clinical care.

Related articles in BJP:

From the Editor's desk

Peter Tyrer
BJP 2007 191: 578. [Full Text]  

Highlights of this issue

Kimberlie Dean
BJP 2007 191: A21. [Full Text]  

This article has been cited by other articles:

				G. Norquist, T. G. McGuire, and S. M. Essock Cost-Effectiveness of Depression Treatment for Adolescents Am J Psychiatry, May 1, 2008; 165(5): 549 - 552. [Full Text] [PDF]