Modeling the Risks and Benefits of Depression Treatment for Children and Young Adults
2012
This article, published in Value in Health, presents a discrete event simulation model to quantify the trade-offs with respect to clinical benefits and the risk of fatal and non-fatal suicidal behavior of alternative treatment strategies for a U.S. pediatric population with major depressive disorder. The authors evaluate treatment strategies including: selective serotonin reuptake inhibitors (SSRIs), cognitive behavioral therapy (CBT), and a combination of both.
The results show that the use of SSRIs is associated with the highest number of suicide-related events, while CBT is associated with the lowest number. Moreover, the strategy with the highest number of symptom-free weeks depends on assumptions made regarding treatment efficacy beyond the 36 weeks for which clinical data is available.
Based on these findings the authors conclude that CBT is favorable with respect to suicide deaths and attempts over combination treatment or SSRIs alone and that any clinical benefits of SSRIs, either alone or in combination with CBT, must be weighed against the expected increase in suicides.
Modeling the Risks and Benefits of Depression Treatment for Children and Young Adults
Source:
Soeteman DI, Miller M, Kim JJ. Modeling the Risks and Benefits of Depression Treatment for Children and Young Adults. Value in Health 2012; 15 (5): 724-729. http://dx.doi.org/10.1016/j.jval.2012.03.1390