Trial reportPsychological medicine2026
Cost-utility and cost-effectiveness of SELFIE, a transdiagnostic ecological momentary intervention for improving self-esteem in youth aged 12-26 years exposed to childhood adversity: Findings from a multicenter randomized controlled trial.
Anouk Boonstra, Maud Daemen, Sander Osstyn, Ron Handels, Ruben Drost, Mary Rose Postma, Iris Hoes-van der Meulen, Nele Volbragt, Dorien Nieman, Philippe Delespaul and 12 more
Abstract readRandomized Controlled TrialMulticenter Study
In one paragraphTrial report in Psychological medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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 registryThe 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 literatureWho cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
4 · The recordCorrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
5 · Who and what moneyAuthors and funding
22 authors.
Anouk BoonstraDepartment of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MHeNs) Research Institute, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.ORCID 0000-0001-7890-9415 Maud DaemenDepartment of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MHeNs) Research Institute, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.ORCID 0000-0002-6059-9428 Sander OsstynDepartment of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MHeNs) Research Institute, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.ORCID 0009-0007-4324-6114 Ron HandelsDepartment of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MHeNs) Research Institute, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.ORCID 0000-0002-8663-0630 Ruben DrostDepartment of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.
Mary Rose PostmaDepartment of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MHeNs) Research Institute, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.ORCID 0000-0002-2650-5686 Nele VolbragtDepartment of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MHeNs) Research Institute, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.
Dorien NiemanDepartment of Psychiatry, Amsterdam University Medical Centre (location AMC), Amsterdam Public Health, Amsterdam, The Netherlands.ORCID 0000-0002-9846-4254 Philippe DelespaulDepartment of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MHeNs) Research Institute, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.ORCID 0000-0001-7420-0898 Marieke van der PluijmDepartment of Psychiatry, Amsterdam University Medical Centre (location AMC), Amsterdam Public Health, Amsterdam, The Netherlands.ORCID 0000-0003-0665-7911 Josefien Johanna Froukje BreedveltDepartment of Psychiatry, Amsterdam University Medical Centre (location AMC), Amsterdam Public Health, Amsterdam, The Netherlands.ORCID 0000-0003-1864-1861 Ramon LindauerDepartment of Child and Adolescent Psychiatry, Amsterdam UMC (location AMC), Amsterdam, The Netherlands.ORCID 0000-0002-0387-1309 Jan BoehnkeCentral Institute of Mental Health, Department of Public Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.ORCID 0000-0003-0249-1870 David van den BergDepartment of Clinical Psychology, Vrije Universiteit, Amsterdam, The Netherlands.ORCID 0000-0002-8797-8217 Lieuwe de HaanDepartment of Psychiatry, Amsterdam University Medical Centre (location AMC), Amsterdam Public Health, Amsterdam, The Netherlands.
Silvia EversDepartment of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.ORCID 0000-0003-1026-570X Filip SmitDepartment of Epidemiology and Biostatistics, Amsterdam University Medical Centers (location VUmc), Amsterdam, The Netherlands.ORCID 0000-0001-9479-3600 Claudi BocktingDepartment of Psychiatry, Amsterdam University Medical Centre (location AMC), Amsterdam Public Health, Amsterdam, The Netherlands.ORCID 0000-0002-9220-9244 Therese van AmelsvoortDepartment of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MHeNs) Research Institute, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.ORCID 0000-0003-1135-5133 Ulrich ReininghausCentral Institute of Mental Health, Department of Public Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
Funding
ZonMw 60-63600-98-346
6 · The paper itselfAbstract
backgroundA novel transdiagnostic blended Ecological Momentary Intervention (EMI) for improving self-esteem in youth who experienced childhood adversity has shown beneficial effects. However, evidence on the cost-effectiveness of SELFIE and EMIs overall is lacking.
methodsIn this RCT-based economic evaluation, participants aged 12-26 years with low self-esteem (<26 on the Rosenberg Self-Esteem Scale [RSES]) and experienced childhood adversity were recruited from specialized mental health services and the general population and randomly allocated to CAU (control condition) or CAU + SELFIE (experimental condition). The Trimbos/iMTA Questionnaire for Costs Associated with Psychiatric Illness (TiC-P), the RSES, and EQ-5D-5L were assessed at baseline, post-intervention, and 6-, 18-, and 24-month follow-up. Incremental cost-effectiveness (ICER) and cost-utility (ICUR) ratios, and acceptability curves, were generated. Sensitivity and subgroup analyses assessed robustness.
resultsFrom a societal perspective, the ICER presented €1,219 per improved point of self-esteem, and the ICUR presented €53,986 per QALY gained. The probability of cost-effectiveness was 26% at a willingness-to-pay (WTP) threshold of €20,000/QALY and 49% at €50,000/QALY. At €50,000/QALY, the probability of cost-effectiveness was 77% from a healthcare perspective (ICUR €15,671/QALY gained) and 87% for participants recruited from specialized mental health services (ICUR €-14,567/QALY gained).
conclusionsAt the societal level, the SELFIE intervention exceeded the WTP threshold. Tests for robustness showed higher probabilities of cost-effectiveness from a healthcare perspective, likely reflecting the absence of educational productivity loss costs in the societal perspective, and in youth recruited from specialized mental health services. The innovative field of blended EMIs yields encouraging first results, urging more cost-effectiveness research.
Indexed as
Adverse Childhood ExperiencesCost-Benefit AnalysisCost-Effectiveness AnalysisEcological Momentary AssessmentSelf ConceptAdolescentAdultChildFemaleHumansMaleYoung Adultchildhood adversitycost-effectivenesscost-utilityecological Momentary Interventionself-esteem
Identifiers
PMID41969051
PMCPMC13079239
What OpenQuestion holds
Textmetadata
LicenceCC BY
Read underepoch 390