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Economic impact of early intervention in people at high risk of psychosis

Published online by Cambridge University Press:  09 April 2009

L. R. Valmaggia ,
P. McCrone ,
M. Knapp ,
J. B. Woolley ,
M. R. Broome ,
P. Tabraham ,
L. C. Johns ,
C. Prescott ,
E. Bramon  and
J. Lappin
...Show all authors
L. R. Valmaggia*
Affiliation:
OASIS and Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK Department of Psychiatry and Neuropsychology, Maastricht University, The Netherlands
P. McCrone
Affiliation:
Centre for the Economics of Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK
M. Knapp
Affiliation:
Centre for the Economics of Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK Personal Social Services Research Unit, London School of Economics, UK
J. B. Woolley
Affiliation:
OASIS and Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK
M. R. Broome
Affiliation:
OASIS and Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK
P. Tabraham
Affiliation:
OASIS and Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK
L. C. Johns
Affiliation:
OASIS and Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK
C. Prescott
Affiliation:
OASIS and Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK
E. Bramon
Affiliation:
OASIS and Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK Lambeth Early Onset Service, South London and Maudsley Trust, UK
J. Lappin
Affiliation:
OASIS and Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK
P. Power
Affiliation:
Lambeth Early Onset Service, South London and Maudsley Trust, UK
P. K. McGuire
Affiliation:
OASIS and Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK
*
*Address for correspondence: L. R. Valmaggia, Ph.D., Department of Psychological Medicine and Psychiatry, PO 67, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. (Email: L.Valmaggia@iop.kcl.ac.uk)
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Abstract

Background

Despite the increasing development of early intervention services for psychosis, little is known about their cost-effectiveness. We assessed the cost-effectiveness of Outreach and Support in South London (OASIS), a service for people with an at-risk mental state (ARMS) for psychosis.

Method

The costs of OASIS compared to care as usual (CAU) were entered in a decision model and examined for 12- and 24-month periods, using the duration of untreated psychosis (DUP) and rate of transition to psychosis as key parameters. The costs were calculated on the basis of services used following referral and the impact on employment. Sensitivity analysis was used to test the robustness of all the assumptions made in the model.

Results

Over the initial 12 months from presentation, the costs of the OASIS intervention were £1872 higher than CAU. However, after 24 months they were £961 less than CAU.

Conclusions

This model suggests that services that permit early detection of people at high risk of psychosis may be cost saving.

Keywords

At-risk mental statecost-effectivenessearly detectionearly interventionpsychosis
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 10 , October 2009 , pp. 1617 - 1626
Copyright
Copyright © Cambridge University Press 2009

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