Cost-Utility of Attachment-Based Compassion Therapy (ABCT) and Mindfulness-Based Stress Reduction (MBSR) in the Management of Depressive, Anxious, and Adjustment Disorders in Mental Health Settings: Economic Evaluation Alongside a Randomized Controlled Trial

Journal article

Objectives: The main objective of this paper was to examine the cost-utility of attachment-based compassion therapy (ABCT) compared to Mindfulness-Based Stress Reduction (MBSR) and treatment-as-usual (TAU) on patients with depressive and/or anxious disorder, or adjustment disorder with depressive and/or anxious symptomatology in terms of effects on quality-adjusted life years (QALYs) as well as healthcare costs from a public healthcare system perspective. Method: A 6-month randomized controlled trial was conducted. Ninety Spanish patients with mental disorders (depressive, anxious, or adjustment disorders) received 8 weekly group sessions of TAU + ABCT, TAU + MBSR, or TAU alone. Data collection took place at pre- and 6-month follow-up. Cost-utility of the two treatment groups (ABCT vs MBSR vs TAU) was compared by examining treatment outcomes in terms of QALYs (obtained with the EQ-5D-3L) and healthcare costs (data about service use obtained with the Client Service Receipt Inventory). Results: Both MBSR and ABCT were more efficient than TAU alone, although the results did not reach statistical significance. Compared to ABCT, MBSR produced an increase both in terms of costs (€53.69, 95% CI [− 571.27 to 513.14]) and effects (0.004 QALYs, 95% CI [− 0.031 to 0.049]); ICUR = €13,422.50/QALY). Both interventions significantly reduced the number of visits to general practice compared to TAU. Conclusions: This study has contributed to the evidence base of mindfulness- and compassion-based programs and provided promising information about the cost-utility of MBSR for patients with emotional disorders. However, the small sample size and short follow-up period limit the generalizability of the findings. Preregistration: Clinicaltrials.gov; NCT03425487

Authors: D’Amico, F; Navarrete, J; Montero-Marín, J; Cardeñosa-Valera, E; Navarro-Gil, M

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Springer
• Journal: Mindfulness
• Volume: 15
• Issue: 3
• Pages: 559-569
• Publication date: 2024-03-04
• DOI: 10.1007/s12671-024-02319-4
• EISSN: 1868-8535
• ISSN: 1868-8527
• Language: English
• Keywords: Medicine; Clinical psychology; Randomized controlled trial; Psychotherapist; Psychology; Mindfulness; Internal medicine; Mental health; Psychological intervention; Economic evaluation; Psychiatry; Quality of life (healthcare); Physical therapy; Mindfulness-based stress reduction