From the Journals

CBT cost effective for depressed teens refusing antidepressants



Brief primary care cognitive-behavioral therapy (CBT) among youth who decline antidepressant therapy appears cost-effective, results of a study found.

“In this study, we demonstrate that brief primary care CBT is a cost-effective treatment option for adolescents with depression and likely generates cost savings over 2 years,” said John F. Dickerson, PhD, of Kaiser Permanente Center for Health Research, Portland, Ore., and his associates


Doctor talking with teen girl.

A total of 212 youth with depression (mean age, 15 years) were randomly assigned to treatment as usual (TAU) or TAU plus brief individual CBT. Clinical outcomes included depression-free days and estimated quality-adjusted life-years.

Youth randomly assigned to CBT plus TAU had 26.8 more depression-free days (P = .043) and 0.067 more quality-adjusted life-years (P = .043) on average, compared with patients receiving TAU over a 12-month period. Also, patients in the CBT group had fewer hospitalizations, compared with patients in the TAU group (1.1% vs. 8.8% during 12 months, and 4.4% vs. 12.1% during 24 months), reported Dr. Dickerson and his colleagues.

By the end of the 24-month follow-up, average total costs were $2,811 among youth randomly assigned to CBT plus TAU and $7,354 among youth assigned TAU (adjusted to 2008 U.S. dollars).

“Many adolescents with depression choose to not initiate or continue antidepressant therapy, which limits their options for depression treatment,” the investigators said. “In this evaluation, it is demonstrated that brief, primary care–based CBT is a cost-effective option for the treatment of depression among adolescents with depression who decline or quickly discontinue pharmacotherapy.”

Read more at Pediatrics (2018. doi: 10.1542/peds.2017-1969).

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