BACKGROUND AND OBJECTIVES: Depression in childhood and adolescence is common and often persists into adulthood. This study assessed the population-level cost-effectiveness of a preventive intervention that screens children and adolescents for symptoms of depression in schools and the subsequent provision of a psychological intervention to those showing elevated signs of depression. The target population for screening comprised 11- to 17-year-old children and adolescents in the 2003 Australian population. METHODS: Economic modeling techniques were used to assess the incremental cost-effectiveness of the intervention compared with no intervention. The perspective was that of the health sector, and outcomes were measured by using disability-adjusted life-years (DALYs). Multivariate probabilistic and univariate sensitivity testing was applied to quantify variations in the model parameters. RESULTS: The modeled psychological intervention had an incremental cost-effectiveness ratio of $5400 per DALY averted, with just 2% of iterations falling above a $50 000 per DALY value-for-money threshold. Results were robust to model assumptions. CONCLUSIONS: After school screening, screening and the psychological intervention represent good value-for-money. Such an intervention needs to be seriously considered in any national package of preventive health services. Acceptability issues, particularly to intervention providers, including schools and mental health professionals, need to be considered before wide-scale adoption.
BACKGROUND AND OBJECTIVES:Depression in childhood and adolescence is common and often persists into adulthood. This study assessed the population-level cost-effectiveness of a preventive intervention that screens children and adolescents for symptoms of depression in schools and the subsequent provision of a psychological intervention to those showing elevated signs of depression. The target population for screening comprised 11- to 17-year-old children and adolescents in the 2003 Australian population. METHODS: Economic modeling techniques were used to assess the incremental cost-effectiveness of the intervention compared with no intervention. The perspective was that of the health sector, and outcomes were measured by using disability-adjusted life-years (DALYs). Multivariate probabilistic and univariate sensitivity testing was applied to quantify variations in the model parameters. RESULTS: The modeled psychological intervention had an incremental cost-effectiveness ratio of $5400 per DALY averted, with just 2% of iterations falling above a $50 000 per DALY value-for-money threshold. Results were robust to model assumptions. CONCLUSIONS: After school screening, screening and the psychological intervention represent good value-for-money. Such an intervention needs to be seriously considered in any national package of preventive health services. Acceptability issues, particularly to intervention providers, including schools and mental health professionals, need to be considered before wide-scale adoption.
Authors: Frances L Lynch; John F Dickerson; Gregory N Clarke; William R Beardslee; V Robin Weersing; Tracy R G Gladstone; Giovanna Porta; David A Brent; Tami L Mark; Lynn L DeBar; Steven D Hollon; Judy Garber Journal: Psychiatr Serv Date: 2019-01-03 Impact factor: 3.084
Authors: Y Y Lee; J J Barendregt; E A Stockings; A J Ferrari; H A Whiteford; G A Patton; C Mihalopoulos Journal: Epidemiol Psychiatr Sci Date: 2016-08-11 Impact factor: 6.892
Authors: Jami F Young; Jason D Jones; Marissa D Sbrilli; Jessica S Benas; Carolyn N Spiro; Caroline A Haimm; Robert Gallop; Laura Mufson; Jane E Gillham Journal: J Clin Child Adolesc Psychol Date: 2018-07-06
Authors: Valeria de Angel; Fernanda Prieto; Tracy R G Gladstone; William R Beardslee; Matías Irarrázaval Journal: Trials Date: 2016-05-06 Impact factor: 2.279
Authors: Benjamin W Van Voorhees; Tracy Gladstone; Stephanie Cordel; Monika Marko-Holguin; William Beardslee; Sachiko Kuwabara; Mark Allan Kaplan; Joshua Fogel; Anne Diehl; Chris Hansen; Carl Bell Journal: Internet Interv Date: 2015-07-23