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Health-economic benefits of treating trauma in psychosis (European Journal of Psychotraumatology)

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Home / Resources / Psychosis/Schizophrenia / Health-economic benefits of treating trauma in psychosis (European Journal of Psychotraumatology)

Health-economic benefits of treating trauma in psychosis

Adding PTSD treatment to care as usual for individuals with psychosis and PTSD seem to yield better health and less PTSD at lower costs.


Article Abstract

“Background: Co-occurrence of posttraumatic stress disorder (PTSD) in psychosis (estimated as 12%) raises personal suffering and societal costs. Health–economic studies on PTSD treatments in patients with a diagnosis of a psychotic disorder have not yet been conducted, but are needed for guideline development and implementation. This study aims to analyse the cost-effectiveness of guideline PTSD therapies in patients with a psychotic disorder.

Methods: This health–economic evaluation alongside a randomized controlled trial included 155 patients with a psychotic disorder in care as usual (CAU), with comorbid PTSD. Participants received eye movement desensitization and reprocessing (EMDR) (n = 55), prolonged exposure (PE) (n = 53) or waiting list (WL) (n = 47) with masked assessments at baseline (T0) and at the two-month (post-treatment, T2) and six-month follow-up (T6). Costs were calculated using the TiC-P interview for assessing healthcare consumption and productivity losses. Incremental cost-effectiveness ratios and economic acceptability were calculated for quality-adjusted life years (EQ-5D-3L-based QALYs) and PTSD ‘Loss of diagnosis’ (LoD, CAPS).

Results: Compared to WL, costs were lower in EMDR (-€1410) and PE (-€501) per patient per six months. In addition, EMDR (robust SE 0.024, t = 2.14, p = .035) and PE (robust SE 0.024, t = 2.14, p = .035) yielded a 0.052 and 0.051 incremental QALY gain, respectively, as well as 26% greater probability for LoD following EMDR (robust SE = 0.096, z = 2.66, p = .008) and 22% following PE (robust SE 0.098, z = 2.28, p = .023). Acceptability curves indicate high probabilities of PTSD treatments being the better economic choice. Sensitivity analyses corroborated these outcomes.

Conclusion: Adding PTSD treatment to CAU for individuals with psychosis and PTSD seem to yield better health and less PTSD at lower costs, which argues for implementation.”

—Description from publisher

Article Access

Open Access

de Bont, P. A., van der Vleugel, B. M., van den Berg, D. P., de Roos, C., Lokkerbol, J., Smit, F., de Jongh, A., van der Gaag, M., & van Minnen, A. (2019). Health-economic benefits of treating trauma in psychosis. European Journal of Psychotraumatology, 10(1), 1565032. Open access: https://dx.doi.org/10.1080/20008198.2018.1565032

View the Resource
Basic Info Collapse

Date
January 21, 2019

Creator(s)
Paul A. J. M. de Bonta, Berber M. van der Vleugel, David P. G. van den Berg

Contributor(s)
Carlijn de Roos, Joran Lokkerbol, Filip Smit, Ad de Jongh, Mark van der Gaag, Agnes van Minnen

Topics
Psychosis/Schizophrenia, PTSD

More Info Collapse

Extent
12 pages

Publisher
Taylor & Francis

Rights
© 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

APA Citation
de Bont, P. A., van der Vleugel, B. M., van den Berg, D. P., de Roos, C., Lokkerbol, J., Smit, F., de Jongh, A., van der Gaag, M., & van Minnen, A. (2019). Health-economic benefits of treating trauma in psychosis. European Journal of Psychotraumatology, 10(1), 1565032. Open access: https://dx.doi.org/10.1080/20008198.2018.1565032

Audience
EMDR Therapists, Other Mental Health Professionals

Language
English

Content Type
Article, Peer-Reviewed, RCT

Access Type
External Resource, Open Access

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