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Cited by 16Schizophrenia research and treatmentHealth Systems, Economic Evaluations, Quality of LifePsychiatric care and mental health services

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A review of economic evaluations of health care for people at risk of psychosis and for first-episode psychosis

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Shields, Gemma E., Buck, Deborah, Varese, Filippo, Yung, Alison R., Thompson, Andrew, Husain, Nusrat, Broome, Matthew R., Upthegrove, Rachel, Byrne, Rory, Davies, Linda M.·2022·BMC Psychiatry
DOI 10.1186/s12888-022-03769-7PMC PMC8851734
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Abstract

Background: Preventing psychotic disorders and effective treatment in first-episode psychosis are key priorities for the National Institute for Health and Care Excellence. This review assessed the evidence base for the cost-effectiveness of health and social care interventions for people at risk of psychosis and for first-episode psychosis. Methods: Electronic searches were conducted using the PsycINFO, MEDLINE and Embase databases to identify relevant published full economic evaluations published before August 2020. Full-text English-language studies reporting a full economic evaluation of a health or social care intervention aiming to reduce or prevent symptoms in people at risk of psychosis or experiencing first-episode psychosis were included. Screening, data extraction, and critical appraisal were performed using pre-specified criteria and forms based on the NHS Economic Evaluation Database (EED) handbook and Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist for economic evaluations. The protocol was registered on the PROSPERO database (CRD42018108226). Results were summarised qualitatively. Results: Searching identified 1,628 citations (1,326 following the removal of duplications). After two stages of screening 14 studies met the inclusion criteria and were included in the review. Interventions were varied and included multidisciplinary care, antipsychotic medication, psychological therapy, and assertive outreach. Evidence was limited in the at-risk group with only four identified studies, though all interventions were found to be cost-effective with a high probability (> 80%). A more substantial evidence base was identified for first-episode psychosis (11 studies), with a focus on early intervention (7/11 studies) which again had positive conclusions though with greater uncertainty. Conclusions: Study findings generally concluded interventions were cost-effective. The evidence for the population who are at-risk of psychosis was limited, and though there were more studies for the population with first-episode psychosis, limitations of the evidence base (including generalisability and heterogeneity across the methods used) affect the certainty of conclusions.

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  • Evidence consistently shows cost-effectiveness of early interventions in psychosis across different health systems.

    “Evidence consistently shows cost-effectiveness of early interventions in psychosis across different health systems.”

    From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [417]

    The Discussion reports favourable results for early intervention programmes in first-episode psychosis across studies from a variety of countries. But one of the identified studies did not find the intervention dominant, and the authors caution that heterogeneous designs and limitations in the evidence reduce certainty. “Consistently shows” overstates their conclusion. (LLM, conf=0.88)

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Research works printed but not linked: 62

  1. Yung AR, Yung AR, Pan Yuen H, Mcgorry PD, Phillips LJ, Kelly D, et al. Mapping the Onset of Psychosis: The Comprehensive Assessment of At-Risk Mental States. Aust New Zeal J Psychiatry. 2005;39:964–71. · DOI
  2. Fusar-Poli P, Bonoldi I, Yung AR, Borgwardt S, Kempton MJ, Valmaggia L, et al. Predicting psychosis: Meta-analysis of transition outcomes in individuals at high clinical risk. Arch Gen Psychiatry. 2012;69:220–9. · DOI · Paper page
  3. Yung AR, Phillips LJ, Yuen HP, Francey SM, McFarlane CA, Hallgren M, et al. Psychosis prediction: 12-Month follow up of a high-risk (“prodromal”) group. Schizophr Res. 2003;60:21–32. · DOI · Paper page
  4. Suvisaari J, Mantere O, Keinänen J, Mäntylä T, Rikandi E, Lindgren M, et al. Is It Possible to Predict the Future in First-Episode Psychosis? Front Psychiatry. 2018;9:580. · DOI
  5. Simon GE, Stewart C, Yarborough BJ, Lynch F, Coleman KJ, Beck A, et al. Mortality rates after the first diagnosis of psychotic disorder in adolescents and young adults. JAMA Psychiat. 2018;75:254–60. · DOI
  6. James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 Diseases and Injuries for 195 countries and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392:1789–858. · DOI · Paper page
  7. Wong C, Davidson L, Anglin D, Link B, Gerson R, Malaspina D, et al. Stigma in families of individuals in early stages of psychotic illness: Family stigma and early psychosis. Early Interv Psychiatry. 2009;3:108–15. · DOI
  8. Kinson RM, Hon C, Lee H, Abdin E Bin, Verma S. Stigma and discrimination in individuals with first episode psychosis; one year after first contact with psychiatric services. Psychiatry Res. 2018;270:298–305. · DOI
  9. Onwumere J, Shiers D, Gaughran F. Physical Health Problems in Psychosis: Is It Time to Consider the Views of Family Carers? Front Psychiatry. 2018;9:668. · DOI
  10. Rodrigues M, Wiener JC, Stranges S, Ryan BL, Anderson KK. The risk of physical multimorbidity in people with psychotic disorders: A systematic review and meta-analysis. Journal of Psychosomatic Research. 2021;140:110315. · DOI
  11. Llorca PM, Lançon C, Hartry A, Brown TM, DiBenedetti DB, Kamat SA, et al. Assessing the burden of treatment-emergent adverse events associated with atypical antipsychotic medications. BMC Psychiatry. 2017;17:1–11. · DOI
  12. Rinaldi M, Killackey E, Smith J, Shepherd G, Singh SP, Craig T. First episode psychosis and employment: A review. Int Rev Psychiatry. 2010;22:148–62. · DOI
  13. Poon AWC, Harvey C, Mackinnon A, Joubert L. A longitudinal population-based study of carers of people with psychosis. Epidemiol Psychiatr Sci. 2017;26:265–75. · DOI
  14. Bonnett LJ, Varese F, Smith CT, Flores A, Yung AR. Individualised prediction of psychosis in individuals meeting at-risk mental state (ARMS) criteria: protocol for a systematic review of clinical prediction models. Diagnostic Progn Res. 2019;3:21. · DOI
  15. Yung AR, Phillips LJ, Yuen HP, McGorry PD. Risk factors for psychosis in an ultra high-risk group: Psychopathology and clinical features. Schizophr Res. 2004;67:131–42. · DOI
  16. Yung AR, McGorry PD, McFarlane CA, Jackson HJ, Patton GC, Rakkar A. Monitoring and care of young people at incipient risk of psychosis. Schizophr Bull. 1996;22:283–303. · DOI
  17. Penttilä M, Jaä̈skel̈ainen E, Hirvonen N, Isohanni M, Miettunen J. Duration of untreated psychosis as predictor of long-term outcome in schizophrenia: Systematic review and meta-analysis. British Journal of Psychiatry. 2014;205:88–94. · DOI · Paper page
  18. Husereau D, Drummond M, Petrou S, Carswell C, Moher D, Greenberg D, et al. Consolidated Health Economic Evaluation Reporting Standards (CHEERS)—Explanation and Elaboration: A Report of the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices Task Force. Value Heal. 2013;16:231–50. · DOI · Paper page
  19. Shields GE, Elvidge J. Challenges in synthesising cost-effectiveness estimates. Syst Rev. 2020;9:289. · DOI
  20. Ising HK, Lokkerbol J, Rietdijk J, Dragt S, Klaassen RMC, Kraan T, et al. Four-year cost-effectiveness of cognitive behavior therapy for preventing first-episode psychosis: The Dutch Early Detection Intervention Evaluation (EDIE-NL) trial. Schizophr Bull. 2017;43:365–74.
  21. Jin H, Tappenden P, MacCabe JH, Robinson S, Byford S. Evaluation of the Cost-effectiveness of Services for Schizophrenia in the UK Across the Entire Care Pathway in a Single Whole-Disease Model. JAMA Netw open. 2020;3(5):e205888. · DOI
  22. Perez J, Jin H, Russo DA, Stochl J, Painter M, Shelley G, et al. Clinical effectiveness and cost-effectiveness of tailored intensive liaison between primary and secondary care to identify individuals at risk of a first psychotic illness (the LEGs study): A cluster-randomised controlled trial. The Lancet Psychiatry. 2015;2:984–93. · DOI
  23. Wijnen BFM, Thielen FW, Konings S, Feenstra T, Van Der Gaag M, Veling W, et al. Designing and Testing of a Health-Economic Markov Model for Prevention and Treatment of Early Psychosis. Expert Rev Pharmacoeconomics Outcomes Res. 2020;20(3):269–79. · DOI
  24. Behan C, Kennelly B, Roche E, Renwick L, Masterson S, Lyne J, et al. Early intervention in psychosis: health economic evaluation using the net benefit approach in a real-world setting. Br J Psychiatry. 2020;217(3):484–90. · DOI
  25. Breitborde NJK, Woods SW, Srihari VH. Multifamily psychoeducation for first-episode psychosis: A cost-effectiveness analysis. Psychiatr Serv. 2009;60:1477–83. · DOI
  26. Angelo C, Vittorio M, Anna M, Antonio P. Cost-effectiveness of treating first-episode psychosis: Five-year follow-up results from an Italian early intervention programme. Early Interv Psychiatry. 2011;5:203–11. · DOI
  27. Hastrup LH, Kronborg C, Bertelsen M, Jeppesen P, Jorgensen P, Petersen L, et al. Cost-effectiveness of early intervention in first-episode psychosis: economic evaluation of a randomised controlled trial (the OPUS study). Br J Psychiatry. 2013;202:35–41. · DOI
  28. Health Quality Ontario. Cognitive behavioural therapy for psychosis: A health technology assessment. Ont Health Technol Assess Ser. 2018;18:1–141.
  29. McCrone P, Craig TKJ, Power P, Garety PA. Cost-effectiveness of an early intervention service for people with psychosis. Br J Psychiatry. 2010;196:377–82. · DOI
  30. Mihalopoulos C, Harris M, Henry L, Harrigan S, McGorry P. Is early intervention in psychosis cost-effective over the long term? Schizophr Bull. 2009;35:909–18. · DOI
  31. Rosenheck R, Leslie D, Sint K, Lin H, Robinson DG, Schooler NR, et al. Cost-effectiveness of comprehensive, integrated care for first episode psychosis in the nimh raise early treatment program. Schizophr Bull. 2016;42:896–906. · DOI
  32. Stant AD, TenVergert EM, Wunderink L, Nienhuis FJ, Wiersma D. Economic consequences of alternative medication strategies in first episode non-affective psychosis. Eur Psychiatry. 2007;22:347–53. · DOI
  33. Wong KK, Chan SKW, Lam MML, Hui CLM, Hung SF, Tay M, et al. Cost-effectiveness of an early assessment service for young people with early psychosis in Hong Kong. Aust N Z J Psychiatry. 2011;45:673–80. · DOI · Paper page
  34. Breitborde NJK, Srihari VH, Woods SW. Review of the operational definition for first-episode psychosis. Early Interv Psychiatry. 2009;3:259–65. · DOI
  35. Crumlish N, Whitty P, Clarke M, Browne S, Kamali M, Gervin M, et al. Beyond the critical period: Longitudinal study of 8-year outcome in first-episode non-affective psychosis. Br J Psychiatry. 2009;194:18–24. · DOI
  36. Marshall M, Lewis S, Lockwood A, Drake R, Jones P, Croudace T. Association between duration of untreated psychosis and outcome in cohorts of first-episode patients: A systematic review. Arch Gen Psychiatry. 2005;62:975–83. · DOI
  37. Carney R, Cotter J, Bradshaw T, Firth J, Yung AR. Cardiometabolic risk factors in young people at ultra-high risk for psychosis: A systematic review and meta-analysis. Schizophrenia Research. 2016;170(2 3):290–300. · DOI
  38. Foley DL, Morley KI. Systematic review of early cardiometabolic outcomes of the first treated episode of psychosis. Archives of General Psychiatry. 2011;68(6):609–16. · DOI
  39. Pérez-Iglesias R, Martínez-García O, Pardo-Garcia G, Amado JA, Garcia-Unzueta MT. Tabares-Seisdedos R, et al. Course of weight gain and metabolic abnormalities in first treated episode of psychosis: The first year is a critical period for development of cardiovascular risk factors. Int J Neuropsychopharmacol. 2014;17(1):41–51. · DOI
  40. Leggett LE, Khadaroo RG, Holroyd-Leduc J, Lorenzetti DL, Hanson H, Wagg A, et al. Measuring resource utilization: A systematic review of validated self-reported questionnaires. Med (United States). 2016;95:e2759.
  41. Aceituno D, Vera N, Prina AM, McCrone P. Cost-effectiveness of early intervention in psychosis: systematic review. Br J Psychiatry. 2019;215:388–94. · DOI · Paper page
  42. Thorn JC, Noble SM, Hollingworth W. Timely and Complete Publication of Economic Evaluations Alongside Randomized Controlled Trials. Pharmacoeconomics. 2013;31:77–85. · DOI
  43. Shields GE, Buck D, Elvidge J, Hayhurst KP, Davies LM. Cost-Effectiveness Evaluations of Psychological Therapies for Schizophrenia and Bipolar Disorder: A Systematic Review. Cambridge University Press. 2019;35(4):317–26.
  44. Shiroiwa T, Sung Y-K, Fukuda T, Lang H-C, Bae S-C, Tsutani K. International survey on willingness-to-pay (WTP) for one additional QALY gained: what is the threshold of cost effectiveness? Health Econ. 2010;19:422–37. · DOI
  45. Claxton K, Martin S, Soares M, Rice N, Spackman E, Hinde S, et al. Methods for the estimation of the National Institute for Health and Care Excellence cost-effectiveness threshold. Health Technol Assess. 2015;19(1–503):v–vi.
  46. Petros N, Cullen AE, Vieira S, Rowland E, King G, Leung WS, et al. Examining service‐user perspectives for the development of a good outcome checklist for individuals at clinical high risk for psychosis. Early Interv Psychiatry. 2020;15(3):606–15 eip.12991. · DOI
  47. Byrne R, Davies L, Morrison AP. Priorities and preferences for the outcomes of treatment of psychosis: A service user perspective. Psychosis. 2010;2:210–7. · DOI
  48. Keetharuth AD, Brazier J, Connell J, Bjorner JB, Carlton J, Buck ET, et al. Recovering Quality of Life (ReQoL): A new generic self-reported outcome measure for use with people experiencing mental health difficulties. Br J Psychiatry. 2018;212:42–9. · DOI
  49. Caro JJ, Briggs AH, Siebert U, Kuntz KM. Modeling good research practices-overview: A report of the ISPOR-SMDM modeling good research practices task force-1. Med Decis Mak. 2012;32:667–77. · DOI · Paper page
  50. Marwaha S, Thompson A, Upthegrove R, Broome MR. Fifteen years on - Early intervention for a new generation. Br J Psychiatry. 2016;209:186–8. · DOI
  51. Hegelstad WTV, Larsen TK, Auestad B, Evensen J, Haahr U, Joa I, et al. Long-term follow-up of the TIPS early detection in psychosis study: Effects on 10-year outcome. Am J Psychiatry. 2012;169:374–80. · DOI
  52. Grutters JPC, Sculpher M, Briggs AH, Severens JL, Candel MJ, Stahl JE, et al. Acknowledging Patient Heterogeneity in Economic Evaluation. Pharmacoeconomics. 2013;31:111–23. · DOI
  53. Barton GR, Hodgekins J, Mugford M, Jones PB, Croudace T, Fowler D. Measuring the benefits of treatment for psychosis: validity and responsiveness of the EQ–5D. Br J Psychiatry. 2009;195:170–7. · DOI
  54. Brazier J. Is the EQ–5D fit for purpose in mental health? Br J Psychiatry. 2010;197:348–9. · DOI
  55. Holt RIG, Gossage-Worrall R, Hind D, Bradburn MJ, McCrone P, Morris T, et al. Structured lifestyle education for people with schizophrenia, schizoaffective disorder and first-episode psychosis (STEPWISE): Randomised controlled trial. Br J Psychiatry. 2019;214:63–73. · DOI
  56. Zhu Y, Li C, Huhn M, Rothe P, Krause M, Bighelli I, et al. How well do patients with a first episode of schizophrenia respond to antipsychotics: A systematic review and meta-analysis. Eur Neuropsychopharmacol. 2017;27:835–44. · DOI
  57. Bagnall AM, Jones L, Ginnelly L, Lewis R, Glanville J, Gilbody S, et al. A systematic review of atypical antipsychotic drugs in schizophrenia. Health Technology Assessment. 2003;7(13):1–193. · DOI
  58. Henrique ICB, Lima T, Melo DO, Aguiar PM. Economic evaluations on the use of aripiprazole for patients with schizophrenia: A systematic review. J Clin Pharm Ther. 2020;45:1–15. · DOI
  59. Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2197–223. · DOI · Paper page
  60. Vos T, Barber RM, Bell B, Bertozzi-Villa A, Biryukov S, Bolliger I, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;386:743–800. · DOI · Paper page
  61. Qurashi I, Chaudhry IB, Khoso AB, Farooque S, Lane S, Husain MO, et al. A randomised, double-blind, placebo-controlled trial of minocycline and/or omega-3 fatty acids added to treatment as usual for at-risk mental states (NAYAB): Study protocol. Trials. 2017;18:524. · DOI
  62. Ologundudu OM, Lau T, Palaniyappan L, Ali S, Anderson KK. Interventions for people at ultra-high risk for psychosis: A systematic review of economic evaluations. Early Intervention in Psychiatry. 2020;15(5):1115–26. · DOI · Paper page

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Authors
Shields, G. E., Buck, D., Varese, F., Yung, A. R., Thompson, A., Husain, N., Broome, M. R., Upthegrove, R., Byrne, R., & Davies, L. M.
Affiliations
  • University of Manchester (GB)
  • Greater Manchester Mental Health NHS Foundation Trust (GB)
  • Deakin University (AU)
  • The University of Melbourne (AU)
  • Birmingham Women’s and Children’s NHS Foundation Trust (GB)
Corresponding author
Shields, Gemma E.
ORCID
Venue
BMC Psychiatry
Publisher
Springer Science and Business Media LLC
Published
2022-02-17
Volume
22
Issue
1
Pages
126-126
ISSN
1471-244X (ISSN-L)
DOI
10.1186/s12888-022-03769-7
PMC
PMC8851734
OpenAlex
W4213362370
Cited by
16
References
5
Citations by year
2026: 3 · 2025: 4 · 2024: 3 · 2023: 4 · 2022: 2
FWCI
0.56
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (publishedVersion, other-oa)
  • Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Deakin Research Online (Deakin University) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
  • Minerva Access (University of Melbourne) (submittedVersion, cc-by)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by)
Funders
Health Technology Assessment Programme (17/31/05)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Keywords
psychosis prevention, first-episode psychosis, cost-effectiveness, economic evaluation, early intervention, antipsychotic drugs, psychotherapy, assertive outreach, multidisciplinary care, social care interventions
MeSH terms
Cost-Benefit Analysis, Delivery of Health Care, Humans, Psychotic Disorders, Antipsychotic Agents, Treatment Outcome

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