Evidence map›Paper›PMID 39500599›Full record

ArticleBMJ mental health2024

Cost-effectiveness of psychological and psychosocial interventions for adults, children and young people who have self-harmed.

Ifigeneia Mavranezouli, Ferruccio Pelone, Rachel Connolly, Faraz Mughal, Katrina G Witt, Keith Hawton, Karen Lascelles, Amanda Wildgoose, Angela Childs, Stephen Pilling and 1 more

Abstract read
In one paragraph

Article in BMJ mental health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
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

11 authors.

Ifigeneia Mavranezouli *Research Department of Clinical, Educational & Health Psychology, University College London, London, UK i.mavranezouli@ucl.ac.uk.ORCID http://orcid.org/0000-0001-9095-3566
Ferruccio Pelone *Royal College of Obstetricians and Gynaecologists, London, UK.
Rachel ConnollyNational Institute for Health and Care Excellence, Manchester, UK.
Faraz MughalSchool of Medicine, Keele University, Keele, UK.ORCID http://orcid.org/0000-0002-5437-5962
Katrina G WittCentre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
Keith HawtonCentre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford, UK.
Karen LascellesOxford Health NHS Foundation Trust, Oxford, UK.
Amanda WildgooseSouth London and Maudsley NHS Foundation Trust, London, UK.
Angela ChildsBerkshire Healthcare NHS Foundation Trust, Bracknell, UK.
Stephen PillingResearch Department of Clinical, Educational & Health Psychology, University College London, London, UK.
Navneet KapurNational Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, The University of Manchester, Manchester, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSelf-harm is a major health issue resulting in high societal costs. Few psychological and psychosocial interventions have shown effectiveness in reducing repeat self-harm.

objectiveTo assess the cost-effectiveness of psychological and psychosocial interventions that have shown evidence of effectiveness in adults and CYP (children and young people) who have self-harmed.

methodsUsing effectiveness data from Cochrane reviews, we developed two decision-analytical models to compare costs and quality-adjusted life years (QALYs) of cognitive behavioural therapy (CBT)-informed psychological therapy added to treatment as usual (TAU) versus TAU alone for adults who have self-harmed, and of dialectical behavioural therapy for adolescents (DBT-A) versus enhanced TAU for CYP who have self-harmed, respectively, from a National Health Service and personal social services perspective in England. Other model input parameters were obtained from published sources, supplemented by expert opinion.

findingsThe incremental cost-effectiveness ratio (ICER) of CBT-informed psychological therapy added to TAU versus TAU alone for adults who have self-harmed was £9088/QALY. The ICER of DBT-A versus enhanced TAU for CYP who have self-harmed was £268 601/QALY. Results were overall robust to the alternative scenarios tested. CONCLUSIONS AND CLINICAL IMPLICATIONS: CBT-informed psychological therapy appears to be cost-effective for adults who have self-harmed, which contributes to evidence for its implementation in services. Currently, DBT-A does not seem to be cost-effective for CYP who have self-harmed. The economic analyses were informed by clinical evidence of moderate-to-low (CBT) and low (DBT-A) quality. Further clinical and economic evidence for DBT-A and other psychological and psychosocial interventions for people who have self-harmed is required.

Indexed as

Cognitive Behavioral TherapyCost-Benefit AnalysisPsychosocial InterventionSelf-Injurious BehaviorAdolescentAdultChildFemaleHumansMaleQuality-Adjusted Life YearsYoung AdultData Interpretation, StatisticalSuicide & self-harm

Identifiers

PMID39500599
PMCPMC11552534

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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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.