Objectives: Social anxiety disorder is one of the most prevalent mental disorders and often manifests in youth or adolescence. Our aim was to determine direct costs of adolescents with social anxiety disorder and the cost-effectiveness of cognitive-behavioral therapy (CBT) and psychodynamic therapy (PDT) compared to waiting list (WL).
Methods: Baseline data (n = 103) of a randomized controlled trial was used to determine direct costs. Cost-effectiveness of CBT and PDT compared to WL was analyzed using quality-adjusted life years (QALYs) based on the EQ-5D index as measure of health effects.
Results: Total six-month direct costs were 809 € (SE 508 €). Especially costs of outpatient physician treatment (325 €; SE 301 €) and psychiatric hospital stays (377 €; SE 258 €) were high. The incremental cost-effectiveness ratio (ICER) of CBT compared to WL was 18,824 €/QALY, with a probability of 63 % for the ICER being below 50,000 €/QALY. PDT did not prove to be cost-effective.
Conclusions: Direct costs were mainly caused by psychiatric hospital stays and outpatient physician treatments. CBT is likely to be cost-effective compared to WL, whereas PDT is unlikely to be cost-effective.
Hintergrund: Ziel war die Analyse direkter Kosten sozialer Angststörung (SAD) bei Jugendlichen und der Kosteneffektivität von CBT bzw. PDT.
Methoden: Multizentrische randomisierte Studie mit N = 103 Patienten. Krankheitskosten wurden zur Baseline und Kosteneffektivität nach der Behandlung analysiert.
Ergebnisse: Direkte 6-Monats-Kosten zu Baseline lagen bei 809 €. Während die inkrementelle Kosten-Effektivitäts-Relation von CBT im Vergleich zur Warteliste bei 18 824 €/QALY lag, war PDT nicht kosteneffektiv.
Zusammenfassung: SAD verursacht hohe direkte Kosten. CBT ist wahrscheinlich kosteneffektiv.
© Georg Thieme Verlag KG Stuttgart · New York.