Kristin D Martinsen, Eline Aas, Jo Magne Ingul, Carina Lisøy, Frode Adolfsen, Lene-Mari Rasmussen, Tore Wentzel-Larsen, Simon-Peter Neumer
{"title":"儿童焦虑和抑郁预防策略的成本效益分析:卫生服务视角。","authors":"Kristin D Martinsen, Eline Aas, Jo Magne Ingul, Carina Lisøy, Frode Adolfsen, Lene-Mari Rasmussen, Tore Wentzel-Larsen, Simon-Peter Neumer","doi":"10.1186/s13034-025-00962-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The rising prevalence of mental health problems presents economic and social challenges with youth anxiety and depression as major contributors. While strengthening preventive measures is essential to mitigate the impacts of these conditions, limited resources necessitate careful prioritization of interventions. This underscores the need for cost-effectiveness studies to inform resource allocation and decision-making.</p><p><strong>Methods: </strong>This study utilized data from a trial employing the MOST framework to optimize a targeted group CBT intervention for youths exhibiting anxiety and depressive symptoms. Experimental strategies were evaluated for cost-effectiveness using real-world data examining intervention costs, child mental health outcomes: anxious and depressive symptoms and quality-adjusted life-years (QALYs). Three intervention factors were examined: delivery format (16 sessions vs. 8 sessions + 8 web-based sessions), parental involvement (five sessions vs. parental brochure), and measurement feedback system (MFS) (feedback vs. no feedback), producing eight intervention strategies. The study included 701 children aged 8 to 12, recruited from 52 public schools in 39 municipalities in Norway. Statistical analysis was conducted using R.</p><p><strong>Results: </strong>For depressive symptoms and QALYs, cost-effective strategies included the long in-person version with low parental involvement and no feedback, and the hybrid format (in-person + web-based sessions) with low parental involvement and no feedback. For depressive symptoms, the hybrid format with parental involvement and no feedback was a feasible strategy. For anxiety symptoms, cost-effective strategies involved the long in-person version with low parental involvement and feedback, and the hybrid format with low parental involvement and feedback.</p><p><strong>Discussion: </strong>In resource-constrained environments, the least resource-intensive strategies can ensure symptom reduction at minimal cost. Parental involvement is a viable alternative under conditions of intermediate resources, balancing costs, and clinical benefits. When symptom reduction is prioritized, and cost is secondary, the long in-person format with low parental involvement and no feedback may be preferable.</p><p><strong>Conclusion: </strong>The study highlights trade-offs between cost containment, reach, and intervention effectiveness. Policymakers must weigh costs against desired levels of symptom reduction when making decisions. Trial registration number Clinical Trials NCT04263558 (Feb 11, 20, Jan 25. 21).</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":"19 1","pages":"107"},"PeriodicalIF":4.6000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486731/pdf/","citationCount":"0","resultStr":"{\"title\":\"Cost-effectiveness analysis of preventive strategies for child anxiety and depression: a health service perspective.\",\"authors\":\"Kristin D Martinsen, Eline Aas, Jo Magne Ingul, Carina Lisøy, Frode Adolfsen, Lene-Mari Rasmussen, Tore Wentzel-Larsen, Simon-Peter Neumer\",\"doi\":\"10.1186/s13034-025-00962-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The rising prevalence of mental health problems presents economic and social challenges with youth anxiety and depression as major contributors. While strengthening preventive measures is essential to mitigate the impacts of these conditions, limited resources necessitate careful prioritization of interventions. This underscores the need for cost-effectiveness studies to inform resource allocation and decision-making.</p><p><strong>Methods: </strong>This study utilized data from a trial employing the MOST framework to optimize a targeted group CBT intervention for youths exhibiting anxiety and depressive symptoms. Experimental strategies were evaluated for cost-effectiveness using real-world data examining intervention costs, child mental health outcomes: anxious and depressive symptoms and quality-adjusted life-years (QALYs). Three intervention factors were examined: delivery format (16 sessions vs. 8 sessions + 8 web-based sessions), parental involvement (five sessions vs. parental brochure), and measurement feedback system (MFS) (feedback vs. no feedback), producing eight intervention strategies. The study included 701 children aged 8 to 12, recruited from 52 public schools in 39 municipalities in Norway. Statistical analysis was conducted using R.</p><p><strong>Results: </strong>For depressive symptoms and QALYs, cost-effective strategies included the long in-person version with low parental involvement and no feedback, and the hybrid format (in-person + web-based sessions) with low parental involvement and no feedback. For depressive symptoms, the hybrid format with parental involvement and no feedback was a feasible strategy. For anxiety symptoms, cost-effective strategies involved the long in-person version with low parental involvement and feedback, and the hybrid format with low parental involvement and feedback.</p><p><strong>Discussion: </strong>In resource-constrained environments, the least resource-intensive strategies can ensure symptom reduction at minimal cost. Parental involvement is a viable alternative under conditions of intermediate resources, balancing costs, and clinical benefits. When symptom reduction is prioritized, and cost is secondary, the long in-person format with low parental involvement and no feedback may be preferable.</p><p><strong>Conclusion: </strong>The study highlights trade-offs between cost containment, reach, and intervention effectiveness. Policymakers must weigh costs against desired levels of symptom reduction when making decisions. 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Cost-effectiveness analysis of preventive strategies for child anxiety and depression: a health service perspective.
Background: The rising prevalence of mental health problems presents economic and social challenges with youth anxiety and depression as major contributors. While strengthening preventive measures is essential to mitigate the impacts of these conditions, limited resources necessitate careful prioritization of interventions. This underscores the need for cost-effectiveness studies to inform resource allocation and decision-making.
Methods: This study utilized data from a trial employing the MOST framework to optimize a targeted group CBT intervention for youths exhibiting anxiety and depressive symptoms. Experimental strategies were evaluated for cost-effectiveness using real-world data examining intervention costs, child mental health outcomes: anxious and depressive symptoms and quality-adjusted life-years (QALYs). Three intervention factors were examined: delivery format (16 sessions vs. 8 sessions + 8 web-based sessions), parental involvement (five sessions vs. parental brochure), and measurement feedback system (MFS) (feedback vs. no feedback), producing eight intervention strategies. The study included 701 children aged 8 to 12, recruited from 52 public schools in 39 municipalities in Norway. Statistical analysis was conducted using R.
Results: For depressive symptoms and QALYs, cost-effective strategies included the long in-person version with low parental involvement and no feedback, and the hybrid format (in-person + web-based sessions) with low parental involvement and no feedback. For depressive symptoms, the hybrid format with parental involvement and no feedback was a feasible strategy. For anxiety symptoms, cost-effective strategies involved the long in-person version with low parental involvement and feedback, and the hybrid format with low parental involvement and feedback.
Discussion: In resource-constrained environments, the least resource-intensive strategies can ensure symptom reduction at minimal cost. Parental involvement is a viable alternative under conditions of intermediate resources, balancing costs, and clinical benefits. When symptom reduction is prioritized, and cost is secondary, the long in-person format with low parental involvement and no feedback may be preferable.
Conclusion: The study highlights trade-offs between cost containment, reach, and intervention effectiveness. Policymakers must weigh costs against desired levels of symptom reduction when making decisions. Trial registration number Clinical Trials NCT04263558 (Feb 11, 20, Jan 25. 21).
期刊介绍:
Child and Adolescent Psychiatry and Mental Health, the official journal of the International Association for Child and Adolescent Psychiatry and Allied Professions, is an open access, online journal that provides an international platform for rapid and comprehensive scientific communication on child and adolescent mental health across different cultural backgrounds. CAPMH serves as a scientifically rigorous and broadly open forum for both interdisciplinary and cross-cultural exchange of research information, involving psychiatrists, paediatricians, psychologists, neuroscientists, and allied disciplines. The journal focusses on improving the knowledge base for the diagnosis, prognosis and treatment of mental health conditions in children and adolescents, and aims to integrate basic science, clinical research and the practical implementation of research findings. In addition, aspects which are still underrepresented in the traditional journals such as neurobiology and neuropsychology of psychiatric disorders in childhood and adolescence are considered.