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Psychiatr Prax 2019; 46(03): 148-155
DOI: 10.1055/a-0733-4999
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Direkte Kosten sozialer Angststörung bei Jugendlichen und Kosteneffektivität der Psychotherapie

Direct Costs of Social Phobia in Adolescents and Cost-Effectiveness of Psychotherapy
Judith Dams
 1   Institut für Gesundheitsökonomie und Versorgungsforschung, Hamburg Center for Health Economics (HCHE), Universitätsklinikum Hamburg-Eppendorf
,
Klaus-Thomas Kronmüller
 2   Klinik für Allgemeine Psychiatrie, Universität Heidelberg
,
Eric Leibing
 3   Klinik für Psychosomatische Medizin und Psychotherapie, Georg-August-Universität Göttingen
,
Regina Steil
 4   Institut für Psychologie, Klinische Psychologie und Psychotherapie, Goethe Universität Frankfurt
,
Peter Henningsen
 5   Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Technische Universität München
,
Falk Leichsenring
 6   Klinik für Psychosomatik und Psychotherapie, Justus-Liebig-Universität Gießen
,
Hamid Peseschkian
 7   Wiesbadener Akademie für Psychotherapie, Wiesbaden
,
Rita Rosner
 8   Katholische Universität Eichstätt-Ingolstadt
,
Simone Salzer
 9   Klinik für Psychosomatische Medizin und Psychotherapie, Georg-August-Universität Göttingen
10   International Psychoanalytik University Berlin
,
Annette Stefini
 2   Klinik für Allgemeine Psychiatrie, Universität Heidelberg
,
Eva Vonderlin
11   Psychologisches Institut Universität Heidelberg
,
Hans-Helmut König
 1   Institut für Gesundheitsökonomie und Versorgungsforschung, Hamburg Center for Health Economics (HCHE), Universitätsklinikum Hamburg-Eppendorf
› Author Affiliations
Further Information

Publication History

Publication Date:
31 October 2018 (online)

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Zusammenfassung

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.

Abstract

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.

Schlüsselwörter

gesundheitsökonomische Evaluation - soziale Angststörungen bei Jugendlichen - Krankheitskosten - Kosteneffektivität

Keywords

health economic evaluation - social anxiety disorder for adolescents - cost-of-illness - cost-effectiveness
 

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