Evidence map›Paper›PMID 28712353›Full record

Trial reportPsychiatric services (Washington, D.C.)2017

Cost-Effectiveness of a PTSD Intervention Tailored for Individuals With Severe Mental Illness.

Eric P Slade, Jennifer D Gottlieb, Weili Lu, Philip T Yanos, Stanley Rosenberg, Steven M Silverstein, Shula K Minsky, Kim T Mueser

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Psychiatric services (Washington, D.C.), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
3.2field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 2 countries.

Eric P SladeDr. Slade is with the Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, and the U.S. Department of Veterans Affairs (VA) Capitol Health Care Network (Veterans Integrated Service Network 5) Mental Illness Research, Education, and Clinical Center. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Lu is with the Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University School of Health Professions, Newark, New Jersey. Dr. Yanos is with the Department of Psychology, John Jay College of Criminal Justice, City University of New York, New York. Dr. Rosenberg is with the Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire. Dr. Silverstein is with the Division of Schizophrenia Research and Dr. Minsky is with the Department of Quality Improvement and the Department of Psychiatry, Rutgers University Behavioral Health Care, Piscataway, New Jersey.
Jennifer D GottliebDr. Slade is with the Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, and the U.S. Department of Veterans Affairs (VA) Capitol Health Care Network (Veterans Integrated Service Network 5) Mental Illness Research, Education, and Clinical Center. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Lu is with the Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University School of Health Professions, Newark, New Jersey. Dr. Yanos is with the Department of Psychology, John Jay College of Criminal Justice, City University of New York, New York. Dr. Rosenberg is with the Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire. Dr. Silverstein is with the Division of Schizophrenia Research and Dr. Minsky is with the Department of Quality Improvement and the Department of Psychiatry, Rutgers University Behavioral Health Care, Piscataway, New Jersey.
Weili LuDr. Slade is with the Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, and the U.S. Department of Veterans Affairs (VA) Capitol Health Care Network (Veterans Integrated Service Network 5) Mental Illness Research, Education, and Clinical Center. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Lu is with the Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University School of Health Professions, Newark, New Jersey. Dr. Yanos is with the Department of Psychology, John Jay College of Criminal Justice, City University of New York, New York. Dr. Rosenberg is with the Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire. Dr. Silverstein is with the Division of Schizophrenia Research and Dr. Minsky is with the Department of Quality Improvement and the Department of Psychiatry, Rutgers University Behavioral Health Care, Piscataway, New Jersey.
Philip T YanosDr. Slade is with the Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, and the U.S. Department of Veterans Affairs (VA) Capitol Health Care Network (Veterans Integrated Service Network 5) Mental Illness Research, Education, and Clinical Center. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Lu is with the Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University School of Health Professions, Newark, New Jersey. Dr. Yanos is with the Department of Psychology, John Jay College of Criminal Justice, City University of New York, New York. Dr. Rosenberg is with the Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire. Dr. Silverstein is with the Division of Schizophrenia Research and Dr. Minsky is with the Department of Quality Improvement and the Department of Psychiatry, Rutgers University Behavioral Health Care, Piscataway, New Jersey.
Stanley RosenbergDr. Slade is with the Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, and the U.S. Department of Veterans Affairs (VA) Capitol Health Care Network (Veterans Integrated Service Network 5) Mental Illness Research, Education, and Clinical Center. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Lu is with the Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University School of Health Professions, Newark, New Jersey. Dr. Yanos is with the Department of Psychology, John Jay College of Criminal Justice, City University of New York, New York. Dr. Rosenberg is with the Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire. Dr. Silverstein is with the Division of Schizophrenia Research and Dr. Minsky is with the Department of Quality Improvement and the Department of Psychiatry, Rutgers University Behavioral Health Care, Piscataway, New Jersey.
Steven M SilversteinDr. Slade is with the Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, and the U.S. Department of Veterans Affairs (VA) Capitol Health Care Network (Veterans Integrated Service Network 5) Mental Illness Research, Education, and Clinical Center. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Lu is with the Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University School of Health Professions, Newark, New Jersey. Dr. Yanos is with the Department of Psychology, John Jay College of Criminal Justice, City University of New York, New York. Dr. Rosenberg is with the Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire. Dr. Silverstein is with the Division of Schizophrenia Research and Dr. Minsky is with the Department of Quality Improvement and the Department of Psychiatry, Rutgers University Behavioral Health Care, Piscataway, New Jersey.
Shula K MinskyDr. Slade is with the Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, and the U.S. Department of Veterans Affairs (VA) Capitol Health Care Network (Veterans Integrated Service Network 5) Mental Illness Research, Education, and Clinical Center. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Lu is with the Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University School of Health Professions, Newark, New Jersey. Dr. Yanos is with the Department of Psychology, John Jay College of Criminal Justice, City University of New York, New York. Dr. Rosenberg is with the Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire. Dr. Silverstein is with the Division of Schizophrenia Research and Dr. Minsky is with the Department of Quality Improvement and the Department of Psychiatry, Rutgers University Behavioral Health Care, Piscataway, New Jersey.
Kim T MueserDr. Slade is with the Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, and the U.S. Department of Veterans Affairs (VA) Capitol Health Care Network (Veterans Integrated Service Network 5) Mental Illness Research, Education, and Clinical Center. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Lu is with the Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University School of Health Professions, Newark, New Jersey. Dr. Yanos is with the Department of Psychology, John Jay College of Criminal Justice, City University of New York, New York. Dr. Rosenberg is with the Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire. Dr. Silverstein is with the Division of Schizophrenia Research and Dr. Minsky is with the Department of Quality Improvement and the Department of Psychiatry, Rutgers University Behavioral Health Care, Piscataway, New Jersey.
University of Maryland, Baltimore · US

Funding

Cognitive-Behavioral Treatment of PTSD in SMI ClientsR01MH064662 · NIMH · DARTMOUTH COLLEGE · PI MUESER, KIM T · 2002 to 2010
$3.7M
NIMH NIH HHS R01 MH064662
6 · The paper itself

Abstract

objectiveThis study examined the cost-effectiveness of a cognitive-behavioral therapy (CBT) intervention for posttraumatic stress disorder (PTSD) that is tailored for adults with a co-occurring severe mental illness.

methodsData were from a randomized trial involving 183 adult clients of two outpatient clinics and three partial hospitalization programs. All had a severe mental illness diagnosis (major mood disorder, schizophrenia, or schizoaffective disorder) and severe PTSD. Participants were randomly assigned to the tailored 12- to 16-session CBT intervention for PTSD (CBT-P) or a three-session breathing retraining and psychoeducation intervention (BRF). Cost estimates included intervention costs for training, supervision, fidelity assessment, personnel, and overhead and related mental health care costs for outpatient, inpatient, and emergency department services and for medications. The incremental cost-effectiveness ratio comparing CBT-P with BRF measured the added cost or savings per remission from PTSD at 12 months postintervention. Generalized linear models were used to estimate intervention effects on annual mental health care costs and the likelihood of a remission from PTSD. Ten thousand bootstrap replications were used to assess uncertainty.

resultsAnnual mean mental health care costs were $25,539 per client (in 2010 dollars) for BRF participants and $29,530 per client for CBT-P participants, a nonsignificant difference. The mean incremental cost-effectiveness ratio was $36,893 per additional PTSD remission yielded by CBT-P compared with BRF (95% confidence interval=-$33,523 to $158,914). Remissions were associated with improvements in quality of life and functioning.

conclusionsAn effective CBT intervention tailored for adults with severe mental illness and PTSD was not found to be more cost-effective than a brief three-session intervention.

Indexed as

Cost-Benefit AnalysisMood DisordersOutcome Assessment, Health CarePsychotic DisordersSchizophreniaAdultCognitive Behavioral TherapyComorbidityFemaleHumansMaleMiddle AgedStress Disorders, Post-TraumaticCognitive therapyCost-effectiveness analysisPosttraumatic stress disorder (PTSD)severe mental illness

Identifiers

PMID28712353
PMCPMC5711573
OpenAlexW2735414108

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.