Cost-Effectiveness of Internet-Delivered Emotion Regulation Therapy for Adolescents With Nonsuicidal Self-Injury: Within-Trial Analysis of a Randomized Controlled Trial.

IF 5.8 2区 医学 Q1 PSYCHIATRY
Jmir Mental Health Pub Date : 2025-08-27 DOI:10.2196/74303
Johan Bjureberg, Olivia Ojala, Björn Rasmusson, Jessica Malmgren, Clara Hellner, Filipa Sampaio, Oskar Flygare
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引用次数: 0

Abstract

Background: Nonsuicidal self-injury (NSSI) is common among adolescents and is associated with adverse clinical outcomes, as well as suicidal behavior. Current treatments are resource-intensive and may not be accessible to all adolescents with NSSI. Internet-delivered emotion regulation individual therapy for adolescents (IERITA) with NSSI disorder is a promising treatment option, but its cost-effectiveness is unknown.

Objective: This study aims to evaluate the cost-effectiveness of IERITA for adolescents with NSSI disorder.

Methods: Within-trial cost-effectiveness analysis of a randomized controlled trial at three child and adolescent mental health services in Sweden (n=166). A total of 12 weeks of IERITA plus treatment as usual (TAU) versus TAU only were compared. The primary outcome was the frequency of NSSI at 1-month posttreatment. Secondary outcomes were NSSI remission and quality-adjusted life years (QALYs).

Results: IERITA led to reductions in NSSI frequency, a higher proportion of participants with NSSI remission, and more QALYs at 1-month posttreatment, at additional health care costs of US $3663 (95% CI US $2182-$5002) and societal costs of US $4458 (95% CI US $-577 to $9509). The incremental cost of one additional NSSI remission at 1-month posttreatment was US $18,677, and the incremental cost per QALY gained was US $792,244 for IERITA+TAU relative to TAU. IERITA had an 8% probability of being cost-effective at a societal willingness-to-pay threshold of US $84,000 for one QALY at 1-month posttreatment, which increased to 18% at 3-months posttreatment.

Conclusions: IERITA delivered adjunctive to TAU led to improvements in NSSI frequency, remission, and QALYs, at additional costs compared to TAU only. This study provides an estimate of the additional cost of delivering IERITA; however, future studies should include longer follow-up periods to better assess the magnitude of the effects on QALYs and societal costs.

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网络情绪调节治疗青少年非自杀性自伤的成本-效果:随机对照试验的试验内分析。
背景:非自杀性自伤(NSSI)在青少年中很常见,并且与不良临床结果和自杀行为相关。目前的治疗是资源密集型的,可能不是所有的青少年自伤都能获得。网络情绪调节个体治疗青少年自伤障碍(IERITA)是一种很有前途的治疗选择,但其成本效益尚不清楚。目的:本研究旨在评估IERITA治疗青少年自伤障碍的成本-效果。方法:对瑞典三家儿童和青少年精神卫生服务机构(n=166)的随机对照试验进行试验内成本-效果分析。总共12周的IERITA加常规治疗(TAU)与仅TAU进行比较。主要终点是治疗后1个月的自伤频率。次要结局是自伤缓解和质量调整生命年(QALYs)。结果:IERITA导致自伤频率降低,自伤缓解的参与者比例更高,治疗后1个月的QALYs更多,额外的医疗费用为3663美元(95% CI为2182- 5002美元),社会成本为4458美元(95% CI为-577 - 9509美元)。治疗后1个月一次额外的自伤缓解的增量成本为18,677美元,IERITA+TAU相对于TAU获得的每个QALY的增量成本为792,244美元。IERITA在治疗后1个月的一次QALY的社会支付意愿阈值为84,000美元时,具有成本效益的概率为8%,而在治疗后3个月时,这一概率增加到18%。结论:与单纯TAU相比,IERITA辅助TAU治疗可以改善自伤频率、缓解和QALYs,但需要额外的费用。这项研究估计了提供IERITA的额外费用;然而,未来的研究应该包括更长的随访期,以更好地评估对质量年和社会成本的影响程度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Jmir Mental Health
Jmir Mental Health Medicine-Psychiatry and Mental Health
CiteScore
10.80
自引率
3.80%
发文量
104
审稿时长
16 weeks
期刊介绍: JMIR Mental Health (JMH, ISSN 2368-7959) is a PubMed-indexed, peer-reviewed sister journal of JMIR, the leading eHealth journal (Impact Factor 2016: 5.175). JMIR Mental Health focusses on digital health and Internet interventions, technologies and electronic innovations (software and hardware) for mental health, addictions, online counselling and behaviour change. This includes formative evaluation and system descriptions, theoretical papers, review papers, viewpoint/vision papers, and rigorous evaluations.
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