Prevention of perinatal depression with counseling in adolescents: a cost-effectiveness analysis

Franta, Gabriel; Hersh, Alyssa R.; Cirino, Nicole; Caughey, Aaron B.

doi:10.1080/14767058.2022.2049746

Cited by 4 publications

(6 citation statements)

References 28 publications

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“…Using a theoretical cohort of 180 000 individuals, a decision analytical model compared outcomes in pregnant adolescents who received counselling interventions versus those who did not. 37 This study found that it is costeffective to refer all pregnant adolescents for preventive counselling interventions. Within the theoretical cohort for counselling, there were 8935 fewer cases of PND, 1606 fewer cases of chronic depression, 166 fewer preterm deliveries, 4 fewer neonatal deaths, 20 fewer cases of sudden infant death syndrome and 1 fewer case of cerebral palsy.…”

Section: Summary Of Studies Including Perinatal Depressionmentioning

confidence: 86%

“… 37 Using a hypothetical cohort, one study found that counselling was a cost-effective preventative measure, leading to fewer cases of perinatal and chronic depression. 37 Another study estimated that group counselling (costing £114 per mother) cost around £73 □ less than individual counselling (£187 per mother) for mothers with PND. 36 This study found that screening for PND costs less than £2 per mother.…”

Section: Discussionmentioning

confidence: 99%

“…4 Counselling was found to be a cost-effective, preventative intervention for pregnant adolescents. 37 Using a hypothetical cohort, one study found that counselling was a cost-effective preventative measure, leading to fewer cases of perinatal and chronic depression. 37 Another study estimated that group counselling (costing £114 per mother) cost around £73 □ less than individual counselling (£187 per mother) for mothers with PND.…”

Section: Discussionmentioning

confidence: 99%

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Health economic evaluations of preventative care for perinatal anxiety and associated disorders: a rapid review

Pisavadia,

Spencer,

Tuersley

et al. 2024

BMJ Open

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ObjectivesPerinatal mental health problems affect one in five women and cost the UK £8.1 billion for every year of births, with 72% of this cost due to the long-term impact on the child. We conducted a rapid review of health economic evaluations of preventative care for perinatal anxiety and associated disorders.DesignThis study adopted a rapid review approach, using principles of the standard systematic review process to generate quality evidence. This methodology features a systematic database search, Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram, screening of evidence, data extraction, critical appraisal and narrative synthesis.Data sourcesPubMed, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Applied Social Sciences Index and Abstracts, PsycINFO and MEDLINE.Eligibility criteria for selecting studiesStudies that evaluated the costs and cost-effectiveness of preventative care for perinatal anxiety and associated disorders carried out within the National Health Service and similar healthcare systems.Data extraction and synthesisA minimum of two independent reviewers used standardised methods to search, screen, critically appraise and synthesise included studies.ResultsThe results indicate a lack of economic evaluation specifically for perinatal anxiety, with most studies focusing on postnatal depression (PND). Interventions to prevent postnatal mental health problems are cost-effective. Modelling studies have also been conducted, which suggest that treating PND with counselling would be cost-effective.ConclusionThe costs of not intervening in maternal mental health outweigh the costs of preventative interventions. Preventative measures such as screening and counselling for maternal mental health are shown to be cost-effective interventions to improve outcomes for women and children.PROSPERO registration numberCRD42022347859.

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Section: Summary Of Studies Including Perinatal Depressionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Health economic evaluations of preventative care for perinatal anxiety and associated disorders: a rapid review

Pisavadia,

Spencer,

Tuersley

et al. 2024

BMJ Open

View full text Add to dashboard Cite

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“…This document will focus primarily on the pharmacologic management of mental health conditions, including perinatal depression. However, more recent data support prevention of perinatal depression among those at high risk (15) through the use of counseling interventions, such as cognitive behavioral therapy (CBT) (eg, Mothers and Babies) (16)(17)(18)(19), and interpersonal therapy (eg, the ROSE [Reach Out, Stay Strong, Essentials for mothers of newborns] program) (20)(21)(22)(23)(24), which has been shown to be cost effective (25). How clinicians can best identify and implement these psychotherapy-based interventions remains an area of active research (26).…”

Section: Depressive Disordersmentioning

confidence: 99%

Treatment and Management of Mental Health Conditions During Pregnancy and Postpartum

2023

Obstetrics &Amp; Gynecology

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PURPOSE:To assess the evidence regarding safety and efficacy of psychiatric medications to treat mental health conditions during pregnancy and lactation. The conditions reviewed include depression, anxiety and anxiety-related disorders, bipolar disorder, and acute psychosis. For information on screening and diagnosis, refer to American College of Obstetricians and Gynecologists (ACOG) Clinical Practice Guideline Number 4, “Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum” (1).TARGET POPULATION:Pregnant or postpartum individuals with mental health conditions with onset that may have predated the perinatal period or may have occurred for the first time in pregnancy or the first year postpartum or may have been exacerbated in that time.METHODS:This guideline was developed using an a priori protocol in conjunction with a writing team consisting of one specialist in obstetrics and gynecology and one maternal–fetal medicine subspecialist appointed by the ACOG Committee on Clinical Practice Guidelines–Obstetrics and two external subject matter experts. ACOG medical librarians completed a comprehensive literature search for primary literature within Cochrane Library, Cochrane Collaboration Registry of Controlled Trials, EMBASE, PubMed, and MEDLINE. Studies that moved forward to the full-text screening stage were assessed by two authors from the writing team based on standardized inclusion and exclusion criteria. Included studies underwent quality assessment, and a modified GRADE (Grading of Recommendations Assessment, Development and Evaluation) evidence-to-decision framework was applied to interpret and translate the evidence into recommendation statements.RECOMMENDATIONS:This Clinical Practice Guideline includes recommendations on treatment and management of perinatal mental health conditions including depression, anxiety, bipolar disorders, and acute postpartum psychosis, with a focus on psychopharmacotherapy. Recommendations are classified by strength and evidence quality. Ungraded Good Practice Points are included to provide guidance when a formal recommendation could not be made because of inadequate or nonexistent evidence.

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“…However, "increased risk" is not defined. Cost-effectiveness analyses on a theoretical cohort of pregnant adolescents have demonstrated effectiveness of counseling interventions for this high-risk group (97).…”

Section: Prevention and Anticipatory Guidancementioning

confidence: 99%

Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum

2023

Obstetrics &Amp; Gynecology

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PURPOSE:To review evidence on the current understanding of mental health conditions in pregnancy and postpartum, with a focus on mood and anxiety disorders, and to outline guidelines for screening and diagnosis that are consistent with best available scientific evidence. The conditions or symptoms reviewed include depression, anxiety and anxiety-related disorders, bipolar disorder, suicidality, and postpartum psychosis. For information on psychopharmacologic treatment and management, refer to American College of Obstetricians and Gynecologists (ACOG) Clinical Practice Guideline Number 5, “Treatment and Management of Mental Health Conditions During Pregnancy and Postpartum” (1).TARGET POPULATION:Pregnant or postpartum individuals with mental health conditions. Onset of these conditions may have predated the perinatal period or may have occurred for the first time in pregnancy or the first year postpartum or may have been exacerbated in that time.METHODS:This guideline was developed using an a priori protocol in conjunction with a writing team consisting of one specialist in obstetrics and gynecology and one maternal–fetal medicine subspecialist appointed by the ACOG Committee on Clinical Practice Guidelines–Obstetrics and two external subject matter experts. ACOG medical librarians completed a comprehensive literature search for primary literature within Cochrane Library, Cochrane Collaboration Registry of Controlled Trials, EMBASE, PubMed, and MEDLINE. Studies that moved forward to the full-text screening stage were assessed by two authors from the writing team based on standardized inclusion and exclusion criteria. Included studies underwent quality assessment, and a modified GRADE (Grading of Recommendations Assessment, Development and Evaluation) evidence-to-decision framework was applied to interpret and translate the evidence into recommendation statements.RECOMMENDATIONS:This Clinical Practice Guideline includes recommendations on the screening and diagnosis of perinatal mental health conditions including depression, anxiety, bipolar disorder, acute postpartum psychosis, and the symptom of suicidality. Recommendations are classified by strength and evidence quality. Ungraded Good Practice Points are included to provide guidance when a formal recommendation could not be made because of inadequate or nonexistent evidence.

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Prevention of perinatal depression with counseling in adolescents: a cost-effectiveness analysis

Cited by 4 publications

References 28 publications

Health economic evaluations of preventative care for perinatal anxiety and associated disorders: a rapid review

Health economic evaluations of preventative care for perinatal anxiety and associated disorders: a rapid review

Treatment and Management of Mental Health Conditions During Pregnancy and Postpartum

Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum

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