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基于互联网的认知行为疗法治疗严重健康焦虑的成本效益和长期疗效。

Cost-effectiveness and long-term effectiveness of internet-based cognitive behaviour therapy for severe health anxiety.

机构信息

Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.

出版信息

Psychol Med. 2013 Feb;43(2):363-74. doi: 10.1017/S0033291712001079. Epub 2012 May 21.

Abstract

BACKGROUND

Severe health anxiety is a common condition associated with functional disability, making it a costly disorder from a societal perspective. Internet-based cognitive behaviour therapy (ICBT) is a promising treatment but no previous study has assessed the cost-effectiveness or long-term outcome of ICBT for severe health anxiety. The aim of this study was to investigate the cost-effectiveness and 1-year treatment effects of ICBT for severe health anxiety.

METHOD

Cost-effectiveness and 1-year follow-up data were obtained from a randomized controlled trial (RCT) comparing ICBT (n = 40) to an attention control condition (CC, n = 41). The primary outcome measure was the Health Anxiety Inventory (HAI). A societal perspective was taken and incremental cost-effectiveness ratios (ICERs) were calculated using bootstrap sampling.

RESULTS

The main ICER was -£1244, indicating the societal economic gain for each additional case of remission when administering ICBT. Baseline to 1-year follow-up effect sizes on the primary outcome measure were large (d = 1.71-1.95).

CONCLUSIONS

ICBT is a cost-effective treatment for severe health anxiety that can produce substantial and enduring effects.

摘要

背景

严重的健康焦虑是一种常见的病症,与功能障碍有关,从社会角度来看,这是一种代价高昂的疾病。基于互联网的认知行为疗法(ICBT)是一种很有前途的治疗方法,但以前没有研究评估过 ICBT 对严重健康焦虑的成本效益或长期效果。本研究旨在探讨 ICBT 治疗严重健康焦虑的成本效益和 1 年治疗效果。

方法

从一项比较 ICBT(n=40)与注意对照组(CC,n=41)的随机对照试验(RCT)中获得了成本效益和 1 年随访数据。主要结局指标是健康焦虑量表(HAI)。采用社会视角,通过自举抽样计算增量成本效益比(ICER)。

结果

主要的 ICER 为-£1244,这表明在实施 ICBT 时,每增加一例缓解,社会经济就会有相应的收益。主要结局指标的基线至 1 年随访的效果大小较大(d=1.71-1.95)。

结论

ICBT 是一种治疗严重健康焦虑的具有成本效益的方法,可以产生显著且持久的效果。

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