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Economics
Cognitive therapy in addition to standard care was more cost effective than standard care alone in bipolar disorder

https://doi.org/10.1136/ebm.11.2.60

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    Lam DH, McCrone P, Wright K, et al. Cost-effectiveness of relapse-prevention cognitive therapy for bipolar disorder: 30-month study. Br J Psychiatry 2005;186:500–6.
    OpenUrlAbstract/FREE Full Text

    
 
 Q In patients with bipolar disorder, is the addition of cognitive therapy to standard care cost effective?

    Clinical impact ratings Psychiatry ★★★★★★☆

    METHODS

    Embedded ImageDesign:

    randomised (allocation concealed*), blinded (outcome assessors),* controlled trial with 30 months’ follow up.

    Embedded ImageSetting:

    Maudsley and Bethlem NHS Trust, London, UK.

    Embedded ImagePatients:

    103 outpatients who were 18–70 years of age (mean age 44 y, 56% women), had DSM-IV bipolar I disorder, relapsed frequently despite the use of mood stabilisers (ie, ⩾2 episodes in previous 2 y or ⩾3 episodes in 5 y), and did not currently fulfil criteria for a bipolar episode. Exclusion criteria: actively suicidal (Beck Depression Inventory suicide item scored 3) or met criteria for substance use disorder.

    Embedded ImageIntervention:

    51 patients received cognitive therapy plus standard care, and 52 patients received standard care alone.

    Embedded ImageOutcomes:

    number of bipolar free days. Costs related to cognitive therapy and contact with mental …

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    Footnotes

    • ↵* See glossary.

    • For correspondence: Professor D H Lam, University of Hull, Hull, UK. Lam{at}hull.ac.uk

    • Source of funding: South London and Maudsley Hospital’s research and development fund.

    Linked Articles

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      BMJ Publishing Group Ltd
      BMJ Evidence-Based Medicine 2006; 11 63a-63a Published Online First: 30 Mar 2006. doi: 10.1136/ebm.11.2.63a