A systematic review of economic evaluations of treatments for borderline personality disorder.
A systematic review of economic evaluations of treatments for borderline personality disorder.
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DOI：
10.1371/journal.pone.0107748
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
König HH
中科院分区：
文献类型：
--
作者：
Brettschneider C;Riedel-Heller S;König HH
边缘型人格障碍是一种常见的精神障碍。它经常与各种精神共病和功能的基本丧失有关。边缘型人格障碍给社会带来了高昂的代价。本研究的目的是对边缘型人格障碍治疗的现有经济学评价进行系统的文献综述。我们在MEDLINE、EMBASE、PsycINFO和NHSEED中进行了系统的文献检索，以获得关于边缘型人格障碍的部分和全部经济学评价。报告的费用数据被夸大到2012年，并使用购买力平价换算成美元，以便进行比较。研究的质量评估是通过卫生经济学标准检查表共识进行的，该检查表是由德尔菲法与23位国际专家合作开发的。我们确定了6个部分和9个全面的经济评价。方法质量为中等（符合质量标准：部分经济评价中为79.2% [SD：15.4%]，全面经济评价中为77.3% [SD：8.5%]）。大多数评价分析了心理治疗干预措施。虽然模棱两可，但大多数证据都存在于辩证行为疗法上。认知行为疗法和以图式为中心的疗法是节省成本的。关于其他干预措施的证据很少。经济学证据不足以得出所有治疗的可靠结论。有些治疗方法可能具有成本效益。大多数证据存在于辩证行为疗法。然而，它是模棱两可的。有必要进一步研究治疗的成本效益，并确定相关的成本类别和验证效果措施。
The borderline personality disorder is a common mental disorder. It is frequently associated with various mental co-morbidities and a fundamental loss of functioning. The borderline personality disorder causes high costs to society. The aim of this study was to perform a systematic literature review of existing economic evaluations of treatments for borderline personality disorder. We performed a systematic literature search in MEDLINE, EMBASE, PsycINFO and NHSEED for partial and full economic evaluations regarding borderline personality disorder. Reported cost data were inflated to the year 2012 and converted into US-$ using purchasing power parities to allow for comparability. Quality assessment of the studies was performed by means of the Consensus on Health Economic Criteria checklist, a checklist developed by a Delphi method in cooperation with 23 international experts. We identified 6 partial and 9 full economic evaluations. The methodical quality was moderate (fulfilled quality criteria: 79.2% [SD: 15.4%] in partial economic evaluations, 77.3% [SD: 8.5%] in full economic evaluations). Most evaluations analysed psychotherapeutic interventions. Although ambiguous, most evidence exists on dialectical-behavioural therapy. Cognitive behavioural therapy and schema-focused therapy are cost-saving. Evidence on other interventions is scarce. The economic evidence is not sufficient to draw robust conclusions for all treatments. It is possible that some treatments are cost-effective. Most evidence exists on dialectical-behavioural therapy. Yet, it is ambiguous. Further research concerning the cost-effectiveness of treatments is necessary as well as the identification of relevant cost categories and the validation of effect measures.
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