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Objective: To evaluate whether or not cases treated with Intensive Short-term Dynamic Psychotherapy (ISTDP) facilitate healthcare cost reduction, whether any observed reduction is greater than that of a control group and whether any such gains would be maintained in follow up.
Design: A quasi-experimental design was employed in which pre and post healthcare cost and usage data were extracted for all ISTDP treated cases from 1999 to 2008 and compared to parallel measures of a control group of cases referred but never treated.
Importance: Psychiatric and psychological disorders result in excess health care service use and costs. Brief psychotherapy methods may be effective across a broad range of mental disorders and could therefore result in healthcare cost reduction.
Objective: To evaluate whether or not cases treated with Intensive Short-term Dynamic Psychotherapy (ISTDP) facilitate healthcare cost reduction, whether any observed reduction is greater than that of a control group and whether any such gains would be maintained in follow up.
Design: A quasi-experimental design was employed in which pre and post healthcare cost and usage data were extracted for all ISTDP treated cases from 1999 to 2008 and compared to parallel measures of a control group of cases referred but never treated.
Setting: Treatments were provided at an urban University based psychotherapy service.
Participants: All cases from the province of Nova Scotia treated within the research time frame were included. 890 patients were included with a very broad range of psychiatric disorders including anxiety, mood, somatoform, personality and psychotic disorders. 192 referred but never see cases served as non randomized controls.
Intervention(s): ISTDP is an emotionally focused form of brief psychotherapy which has supportive, cognitive, experiential and primarily psychodynamic elements. In this setting the average length of treatment was 7.3 sessions and cost an estimated $500 dollars per treatment course.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ISTDP | Patients provided Intensive Short term Dynamic Psychotherapy |
| |
| Control Group | Patients referred for ISTDP but never seen for any reason |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ISTDP | Behavioral | An emotion focused brief psychotherapy format. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Total Doctor and Hospital Costs | Total Physician and Hospital billings per patient | 1 year pre versus 3 years post |
| Measure | Description | Time Frame |
|---|---|---|
| Hospital costs | Total Hospital costs per patient | 1 year pre versus 3 years post |
| Hospital Days | Hospital days per patient | 1 year per versus 3 years post |
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Inclusion Criteria:
Exclusion Criteria:
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All Major DSM IV categories included including mood, anxiety, personality, somatoform, dissociative, eating and psychotic disorders
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| Name | Affiliation | Role |
|---|---|---|
| Allan A Abbass, MD, FRCPC | Nova Scotia Health Authority | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Capital Health | Halifax | Nova Scotia | B3H 2E2 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25840829 | Derived | Abbass A, Kisely S, Rasic D, Town JM, Johansson R. Long-term healthcare cost reduction with Intensive Short-term Dynamic Psychotherapy in a tertiary psychiatric service. J Psychiatr Res. 2015 May;64:114-20. doi: 10.1016/j.jpsychires.2015.03.001. Epub 2015 Mar 25. |
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| ID | Term |
|---|---|
| D001008 | Anxiety Disorders |
| D013001 | Somatoform Disorders |
| D010554 | Personality Disorders |
| D003863 | Depression |
| D011618 | Psychotic Disorders |
| ID | Term |
|---|---|
| D001523 | Mental Disorders |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D019967 | Schizophrenia Spectrum and Other Psychotic Disorders |
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| Doctor Visits | Doctor Costs per patient | 1 year pre versus 3 years post |
| Doctor Costs | Doctor costs per patient | 1 year pre versus 3 years post |