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The costs and effectiveness of two psychosocial treatment programmes for personality disorder: a controlled study

Published online by Cambridge University Press:  16 April 2020

Jennifer Beecham ,
Michelle Sleed ,
Martin Knapp ,
Marco Chiesa  and
Carla Drahorad
Jennifer Beecham*
Affiliation:
PSSRU, Cornwallis Building, University of Kent, Canterbury CT2 7NF, UK CEMH, Institute of Psychiatry, UK
Michelle Sleed
Affiliation:
PSSRU, Cornwallis Building, University of Kent, Canterbury CT2 7NF, UK
Martin Knapp
Affiliation:
CEMH, Institute of Psychiatry, UK PSSRU, London School of Economics, London, UK
Marco Chiesa
Affiliation:
Cassel Hospital, UK
Carla Drahorad
Affiliation:
Cassel Hospital, UK
*
*Corresponding author. Tel.: +44 1227 82 3792; fax: +44 1227 82 7038. E-mail address:[email protected] (J. Beecham).
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Abstract

This paper examines the costs and cost-effectiveness of psychosocial treatment for personality disorder in a controlled study. Using well-validated cost and outcome measures three groups are compared: the One-Stage group (n = 32) received 12 months of inpatient treatment; the Step-Down group (n = 29) received 6 months of inpatient treatment followed by 12 months of outpatient therapy; and the control group of 47 people used routinely available services. Both specialist programmes were more effective than routine psychiatric services but more costly. Using an extended dominance approach the incremental cost-effectiveness ratio showed that achieving one extra person with clinically relevant outcomes required an investment in the Step-Down programme of around £3400 over 18 months. Small sample sizes and non-random allocation to programmes are limitations of this study but the costs and effectiveness findings consistently point to advantages for the shorter residential programme followed by community-based psychotherapeutic support.

Keywords

CostCost-effectivenessPersonality disorderInpatient treatment
Type
Original article
Information
European Psychiatry , Volume 21 , Issue 2 , March 2006 , pp. 102 - 109
Copyright
Copyright © Elsevier SAS 2006

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