Evaluating the Cost Effectiveness of ISTDP: A Quasi Experimental Study (CEISTDP)

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.

Study Overview

• Status: Completed
• Conditions: Personality Disorders; Depression; Psychotic Disorders; Anxiety; Somatoform Disorders
• Intervention / Treatment: Behavioral: ISTDP

Detailed Description

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.

• Study Type: Observational
• Enrollment (Actual): 1082

Contacts and Locations

Study Locations

• Canada
  • Nova Scotia
    • Halifax, Nova Scotia, Canada, B3H 2E2
      • Capital Health

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 12 years to 90 years (ADULT, OLDER_ADULT, CHILD)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

All Major DSM IV categories included including mood, anxiety, personality, somatoform, dissociative, eating and psychotic disorders

Description

Inclusion Criteria:

• All patients referred for ISTDP treatment

Exclusion Criteria:

• Patients not referred for ISTDP treatment

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
ISTDP; Patients provided Intensive Short term Dynamic Psychotherapy	Behavioral: ISTDP; An emotion focused brief psychotherapy format.; Other Names: Intensive Short-term Dynamic Psychotherapy
Control Group; Patients referred for ISTDP but never seen for any reason

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Total Doctor and Hospital Costs	Total Physician and Hospital billings per patient	1 year pre versus 3 years post

Secondary Outcome Measures

Outcome Measure	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
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

Collaborators and Investigators

• Sponsor: Nova Scotia Health Authority
• Investigators: Principal Investigator: Allan A Abbass, MD, FRCPC, Nova Scotia Health Authority

Publications and helpful links

General Publications

• 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.

Study record dates

Study Major Dates

• Study Start: January 1, 2008
• Primary Completion (ACTUAL): March 1, 2009
• Study Completion (ACTUAL): March 1, 2009

Study Registration Dates

• First Submitted: July 25, 2013
• First Submitted That Met QC Criteria: August 15, 2013
• First Posted (ESTIMATE): August 16, 2013

Study Record Updates

• Last Update Posted (ESTIMATE): August 16, 2013
• Last Update Submitted That Met QC Criteria: August 15, 2013
• Last Verified: July 1, 2013

More Information

Terms related to this study

• Keywords: depression; anxiety; psychotherapy; personality disorder; somatoform disorder
• Additional Relevant MeSH Terms: Behavioral Symptoms; Pathologic Processes; Schizophrenia Spectrum and Other Psychotic Disorders; Personality Disorders; Depression; Disease; Psychotic Disorders; Mental Disorders; Somatoform Disorders
• Other Study ID Numbers: AA003