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Cost-effectiveness of twice-weekly versus once-weekly sessions of cognitive–behavioural therapy and interpersonal psychotherapy for depression at 12 months after start of treatment: randomised controlled trial
- Judith E. Bosmans, Sanne J. E. Bruijniks, Mohamed El Alili, Steven D. Hollon, Frenk P. M. L. Peeters, Arnoud Arntz, Pim Cuijpers, Lotte H. J. M. Lemmens, Pieter Dingemanse, Linda Willems, Patricia van Oppen, Michael van den Boogaard, Jan Spijker, Jos W. R. Twisk, Marcus J. H. Huibers
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- BJPsych Open / Volume 9 / Issue 6 / November 2023
- Published online by Cambridge University Press:
- 13 October 2023, e186
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Background
Cost-effective treatments are needed to reduce the burden of depression. One way to improve the cost-effectiveness of psychotherapy might be to increase session frequency, but keep the total number of sessions constant.
AimTo evaluate the cost-effectiveness of twice-weekly compared with once-weekly psychotherapy sessions after 12 months, from a societal perspective.
MethodAn economic evaluation was conducted alongside a randomised controlled trial comparing twice-weekly versus once-weekly sessions of psychotherapy (cognitive–behavioural therapy or interpersonal psychotherapy) for depression. Missing data were handled by multiple imputation. Statistical uncertainty was estimated with bootstrapping and presented with cost-effectiveness acceptability curves.
ResultsDifferences between the two groups in depressive symptoms, physical and social functioning, and quality-adjusted life-years (QALY) at 12-month follow-up were small and not statistically significant. Total societal costs in the twice-weekly session group were higher, albeit not statistically significantly so, than in the once-weekly session group (mean difference €2065, 95% CI −686 to 5146). The probability that twice-weekly sessions are cost-effective compared with once-weekly sessions was 0.40 at a ceiling ratio of €1000 per point improvement in Beck Depression Inventory-II score, 0.32 at a ceiling ratio of €50 000 per QALY gained, 0.23 at a ceiling ratio of €1000 per point improvement in physical functioning score and 0.62 at a ceiling ratio of €1000 per point improvement in social functioning score.
ConclusionsBased on the current results, twice-weekly sessions of psychotherapy for depression are not cost-effective over the long term compared with once-weekly sessions.
Long-term outcomes of once weekly v. twice weekly sessions of cognitive behavioral therapy and interpersonal psychotherapy for depression
- Sanne J. E. Bruijniks, Steven D. Hollon, Lotte H. J. M. Lemmens, Frenk P. M. L. Peeters, Arnoud Arntz, Pim Cuijpers, Jos Twisk, Pieter Dingemanse, Linda Willems, Patricia van Oppen, Michael van den Boogaard, Jan Spijker, Marcus J. H. Huibers
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- Journal:
- Psychological Medicine / Volume 54 / Issue 3 / February 2024
- Published online by Cambridge University Press:
- 04 September 2023, pp. 517-526
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Background
Twice weekly sessions of cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for major depressive disorder (MDD) lead to less drop-out and quicker and better response compared to once weekly sessions at posttreatment, but it is unclear whether these effects hold over the long run.
AimsCompare the effects of twice weekly v. weekly sessions of CBT and IPT for depression up to 24 months since the start of treatment.
MethodsUsing a 2 × 2 factorial design, this multicentre study randomized 200 adults with MDD to once or twice weekly sessions of CBT or IPT over 16–24 weeks, up to a maximum of 20 sessions. Main outcome measures were depression severity, measured with the Beck Depression Inventory-II and the Longitudinal Interval Follow-up Evaluation. Intention-to-treat analyses were conducted.
ResultsCompared with patients who received once weekly sessions, patients who received twice weekly sessions showed a significant decrease in depressive symptoms up through month 9, but this effect was no longer apparent at month 24. Patients who received CBT showed a significantly larger decrease in depressive symptoms up to month 24 compared to patients who received IPT, but the between-group effect size at month 24 was small. No differential effects between session frequencies or treatment modalities were found in response or relapse rates.
ConclusionsAlthough a higher session frequency leads to better outcomes in the acute phase of treatment, the difference in depression severity dissipated over time and there was no significant difference in relapse.
The effects of once- versus twice-weekly sessions on psychotherapy outcomes in depressed patients
- Sanne J. E. Bruijniks, Lotte H. J. M. Lemmens, Steven D. Hollon, Frenk P. M. L. Peeters, Pim Cuijpers, Arnoud Arntz, Pieter Dingemanse, Linda Willems, Patricia van Oppen, Jos W. R. Twisk, Michael van den Boogaard, Jan Spijker, Judith Bosmans, Marcus J. H. Huibers
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- The British Journal of Psychiatry / Volume 216 / Issue 4 / April 2020
- Published online by Cambridge University Press:
- 07 February 2020, pp. 222-230
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- April 2020
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Background
It is unclear what session frequency is most effective in cognitive–behavioural therapy (CBT) and interpersonal psychotherapy (IPT) for depression.
AimsCompare the effects of once weekly and twice weekly sessions of CBT and IPT for depression.
MethodWe conducted a multicentre randomised trial from November 2014 through December 2017. We recruited 200 adults with depression across nine specialised mental health centres in the Netherlands. This study used a 2 × 2 factorial design, randomising patients to once or twice weekly sessions of CBT or IPT over 16–24 weeks, up to a maximum of 20 sessions. Main outcome measures were depression severity, measured with the Beck Depression Inventory-II at baseline, before session 1, and 2 weeks, 1, 2, 3, 4, 5 and 6 months after start of the intervention. Intention-to-treat analyses were conducted.
ResultsCompared with patients who received weekly sessions, patients who received twice weekly sessions showed a statistically significant decrease in depressive symptoms (estimated mean difference between weekly and twice weekly sessions at month 6: 3.85 points, difference in effect size d = 0.55), lower attrition rates (n = 16 compared with n = 32) and an increased rate of response (hazard ratio 1.48, 95% CI 1.00–2.18).
ConclusionsIn clinical practice settings, delivery of twice weekly sessions of CBT and IPT for depression is a way to improve depression treatment outcomes.
Long-term outcomes of acute treatment with cognitive therapy v. interpersonal psychotherapy for adult depression: follow-up of a randomized controlled trial
- Lotte H.J.M. Lemmens, Suzanne C. van Bronswijk, Frenk Peeters, Arnoud Arntz, Steven D. Hollon, Marcus J.H. Huibers
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- Journal:
- Psychological Medicine / Volume 49 / Issue 3 / February 2019
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- 24 May 2018, pp. 465-473
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Background
Although equally efficacious in the acute phase, it is not known how cognitive therapy (CT) and interpersonal psychotherapy (IPT) for major depressive disorder (MDD) compare in the long run. This study examined the long-term outcomes of CT v. IPT for MDD.
MethodsOne hundred thirty-four adult (18–65) depressed outpatients who were treated with CT (n = 69) or IPT (n = 65) in a large open-label randomized controlled trial (parallel group design; computer-generated block randomization) were monitored across a 17-month follow-up phase. Mixed regression was used to determine the course of self-reported depressive symptom severity (Beck Depression Inventory II; BDI-II) after treatment termination, and to test whether CT and IPT differed throughout the follow-up phase. Analyses were conducted for the total sample (n = 134) and for the subsample of treatment responders (n = 85). Furthermore, for treatment responders, rates of relapse and sustained response were examined for self-reported (BDI-II) and clinician-rated (Longitudinal Interval Follow-up Evaluation; LIFE) depression using Cox regression.
ResultsOn average, the symptom reduction achieved during the 7-month treatment phase was maintained across follow-up (7–24 months) for CT and IPT, both in the total sample and in the responder sample. Two-thirds (67%) of the treatment responders did not relapse across the follow-up period on the BDI-II. Relapse rates assessed with the LIFE were somewhat lower. No differential effects between conditions were found.
ConclusionsPatients who responded to IPT were no more likely to relapse following treatment termination than patients who responded to CT. Given that CT appears to have a prophylactic effect following successful treatment, our findings suggest that IPT might have a prophylactic effect as well.
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. 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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. 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Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- Book:
- The Cambridge Dictionary of Christianity
- Published online:
- 05 August 2012
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- 20 September 2010, pp xi-xliv
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The Effects of Small Concentrations of Oxygen in RTP Annealing of Low Energy Boron, BF2 and Arsenic Ion Implants
- Daniel F. Downey, Judy W. Chow, Wilfried Lerch, Juergen Niess, Steven D. Marcus
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- Journal:
- MRS Online Proceedings Library Archive / Volume 525 / 1998
- Published online by Cambridge University Press:
- 10 February 2011, 263
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- 1998
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Ion implants of 1.0 keV 11B+, 5 keV BF 2+, and 2.0 keV As+ at a dose of IeI5/cm2 were rapid thermal annealed (RTA) in a STEAG AST-2800µ with varying percents of oxygen in N2, ranging from 0-lppm to 50,000 ppm to investigate the effects of low concentrations of oxygen during anneal. Sheet resistance (Rs), ellipsometry, SIMS, Tapered Groove Profilometry (TGP), and Scanning Force Microscopy (SFM) were employed to characterize these layers. For each of these implant cases, an optimal RTA condition is established which maximizes retained dose while still producing shallow junctions. As a function of O2 content, anneal temperature and implant condition, three regimes are observed that affect after anneal retained dose. These regimes are: dopant loss to the ambient resulting from etching of Si, dopant loss by out-diffusion from evaporation/chemical reactions, a capping regime that minimizes out-diffusion. In this later regime the dopant loss results from consumption into the RTA grown oxide. In addition, this paper also discusses oxidation enhanced diffusion (OED) and identifies its extent as a function of temperature and O2 content of the anneal for the three implant conditions investigated. For example, a 1.0 keV 11B+wafer annealed at 1050°C lOs in a controlled 33 ppm of O2 in N2 yields a SIMS junction depth 320 Å shallower than previously reported by others.
Rapid Thermal Process Requirements for The Annealing of Ultra-Shallow Junctions
- Daniel F. Downey, Sonu L. Daryanani, Marylou Meloni, Kristen M. Brown, Susan B. Felch, Brian S. Lee, Steven D. Marcus, Jeff Gelpey
-
- Journal:
- MRS Online Proceedings Library Archive / Volume 470 / 1997
- Published online by Cambridge University Press:
- 10 February 2011, 299
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- 1997
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2. 0 keV 11B+, 2.2 keV 49BF2+ ion implanted and 1.0 kV Plasma Doped (PLAD) wafers of a dose of 1E15/cm2 were annealed at various times and temperatures in a variety of ambiente: 600 to 50,000 ppm O2 in N2; 5% NH3 in N2; N2O; N2 or Ar, in order to investigate the effects of the annealing ambient on the formation of ultra-shallow junctions. RGA data was collected during some (if the anneals to assist in identifying the complex surface chemistry responsible for boron out-diffusion. Subsequent to the anneals, ellipsometric, XPS, four-point probe sheet resistance and SJJVIS measurements were performed to further elucidate the effects of the different ambients on the r etained boron dose, the sheet resistance value, the RTP grown oxide layer and the junction depth. In the cases where oxygen was present, e.g. N2O and O2 in N2, an oxidation enhanced diffusion of the boron was observed. This was most dramatic for the N2O anneals, which at 1050°C 10s diffused the boron an additional 283 to 427 Å, depending on the particular doping condition and species. For the case of BF2 implants and PLAD, anneals in 5% NH3 in N2 reduced the junction depth by a nitridation reduced diffusion mechanism. RGA data indicated that the out-diffusion mechanisms for B and BF2 implanted wafers are different, with the BF2 exhibiting dopant loss mechanisms during the 950°C anneals, producing F containing compounds. B implants did not show doping loss mechanisms, ais observed by the RGA, until the 1050°C anneals and these signals did not contain F containing compounds. Equivalent effective energy boron implants of 8.9 keV BF2 vs. 2.0 keV B, however, indicated that the overall effect of the F in the BF2 implants is very beneficial in the creation of ultra-shallow junctions (compared to B implants): reducing the junction depth by 428 Å, and increasing the electrical activation (determined by SRP) by 11.7%, even though the retained dose (resulting from an increased out-diffusion of B), was decreased by 5.4%.
Tisi2 Characterization of CVD-Titanium and RTP on a Cluster Platform–an Initial Investigation
- Steven D. Marcus, Lutz Deutschmann
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- Journal:
- MRS Online Proceedings Library Archive / Volume 387 / 1995
- Published online by Cambridge University Press:
- 15 February 2011, 437
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- 1995
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The silicidation of chemical vapor deposited (CVD) titanium has been investigated utilizing the Materials Research Corporation (MRC) PHOENIX™ cluster-tool platform which incorporated an AST elektronik GmbH cluster RTP chamber. This initial investigation focuses on C49 and C54 TiSi2 phase formation on bare silicon wafers. Equipment description, process results, comparison to classical PVD Ti silicide processing and future investigations will be presented.