Psychiatrische Behandlungskosten von Patientinnen mit Posttraumatischer Belastungsstörung nach sexuellem Missbrauch vor und nach stationärer DBT-PTSD

Priebe, Kathlen; Roth, Mascha; Krüger, Antje; Glöckner-Fink, Kristina; Dyer, Anne; Steil, Regina; Salize, Hans-Joachim; Kleindienst, Nikolaus; Bohus, Martin

doi:10.1055/s-0042-106068

Cited by 9 publications

(17 citation statements)

References 30 publications

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“…Unfortunately, no cost data for young patients with PTSD or a representative sample of adolescents and young adults of the general population in Germany have been published. One study reported costs for the German health care system for adult with PTSD (12). In line with our results, high 6-month costs for psychiatric inpatient (7,596€) and outpatient (825€) treatment were observed.…”

Section: Costssupporting

confidence: 89%

“…Even though the consequences of PTSD are significant, only a limited number of health economic studies addressing PTSD after sexual abuse exist (7,(12)(13)(14)(15)(16). Most of these studies analyzed data of adult patients with PTSD (12)(13)(14). The economic burden was reported to be high.…”

Section: Introductionmentioning

confidence: 99%

“…Annual costs ranged between 3,060 US$ and 18,100€ per adult patient. Costs due to psychiatric treatment were reported to be particularly high in a German study of adults with PTSD (12). However, in younger age groups, PTSD may have a specific impact on the utilisation of health care and health-related quality of life, as well as on the educational development of patients.…”

Section: Introductionmentioning

confidence: 99%

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Health-Related Quality of Life and Costs of Posttraumatic Stress Disorder in Adolescents and Young Adults in Germany

et al. 2020

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Background: Posttraumatic stress disorder (PTSD) is one of the psychopathological consequences of sexual and/or physical abuse. The economic burden is assumed to be high, whereas health-related quality of life and education is negatively affected. This study aims to determine health care costs, health-related quality of life, and educational interruption in adolescents and young adults with PTSD after sexual and/or physical abuse in Germany. Methods: This analysis used data of 87 participants aged 14-21 years of a randomized controlled trial. Health care utilization, health-related quality of life (EQ-5D-5L), sick leave days, productivity, and delay or failure to achieve educational aims were assessed. Health care costs from a payer perspective were calculated using unit costs for the year 2014. Results: Mean health care costs for a six-month period were 5,243€ (SE 868€). In particular, costs of inpatient stays in psychiatric hospitals, general hospitals and rehabilitation as well as child welfare institutions were high. In addition, health-related quality of life was lower due to anxiety/depression, resulting in a mean EQ-5D index and EQ-VAS score of 0.70 and 61.0, respectively. Furthermore, participants reported on average 27 sick leave days, a productivity loss of 61%, and a delay in education attainment as well as having been unable to achieve educational aims. Conclusion: PTSD in adolescents and young adults is associated with a high economic burden. Health-related quality of life was substantially reduced. Furthermore, delay and productivity losses in education were observed.

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Section: Costssupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Health-Related Quality of Life and Costs of Posttraumatic Stress Disorder in Adolescents and Young Adults in Germany

et al. 2020

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“…Apart from the individual suffering, economic costs for treatment and functional impairment (e.g., unemployment) are a heavy burden for the health care system. Data from our group on economic aspects of patients with PTSD and severe emotion dysregulation like BPD, in Germany indicate average direct and indirect costs of about €28.000 per patient (2/3 direct treatment costs) for a period of 1 year, and further indicate that within the German health system, co-morbidity as well as severity of PTSD is related to higher direct costs for healthcare [20, 21].…”

Section: Introductionmentioning

confidence: 99%

A research programme to evaluate DBT-PTSD, a modular treatment approach for Complex PTSD after childhood abuse

Bohus

Schmahl

Fydrich

et al. 2019

bord personal disord emot dysregul

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Background: Posttraumatic stress disorder (PTSD) after childhood abuse (CA) is often related to severe co-occurring psychopathology, such as symptoms of borderline personality disorder (BPD). The ICD-11 has included Complex PTSD as a new diagnosis, which is defined by PTSD symptoms plus disturbances in emotion regulation, self-concept, and interpersonal relationships. Unfortunately, the empirical database on psychosocial treatments for survivors of CA is quite limited. Furthermore, the few existing studies often have either excluded subjects with self-harm behaviour and suicidal ideationwhich is common behaviour in subjects suffering from Complex PTSD. Thus, researchers are still trying to identify efficacious treatment programmes for this group of patients. We have designed DBT-PTSD to meet the specific needs of patients with Complex PTSD. The treatment programme is based on the rules and principles of dialectical behavioural therapy (DBT), and adds interventions derived from cognitive behavioural therapy, acceptance and commitment therapy and compassion-focused therapy. DBT-PTSD can be provided as a comprehensive residential programme or as an outpatient programme. The effects of the residential programme were evaluated in a randomised controlled trial. Data revealed significant reduction of posttraumatic symptoms, with large between-group effect sizes when compared to a treatment-as-usual wait list condition (Cohen's d = 1.5). The first aim of this project on hand is to evaluate the efficacy of the outpatient DBT-PTSD programme. The second aim is to identify the major therapeutic variables mediating treatment efficacy. The third aim is to study neural mechanisms and treatment sensitivity of two frequent sequelae of PTSD after CA: intrusions and dissociation. Methods: To address these questions, we include female patients who experienced CA and who fulfil DSM-5 criteria for PTSD plus borderline features, including criteria for severe emotion dysregulation. The study is funded by the German Federal Ministry of Education and Research, and started in 2014. Participants are randomised to outpatient psychotherapy with either DBT-PTSD or Cognitive Processing Therapy. Formal power analysis revealed a minimum of 180 patients to be recruited. The primary outcome is the change on the Clinician-Administered PTSD Scale for DSM-5. Discussion: The expected results will be a major step forward in establishing empirically supported psychological treatments for survivors of CA suffering from Complex PTSD. Trial registration: German Clinical Trials Register: registration number DRKS00005578, date of registration 19 December 2013.

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“…Nevertheless, in terms of health care services utilization (HCSU) of recently arrived refugees in Germany, no comprehensive analysis has been published so far. A systematic review of HCSU of people with a migrant background in Germany concluded that persons with a migrant background utilized health care less often than persons without a migrant background [ 22 ]. Likewise, an exploratory study analyzing disparities in access to health care among asylum seekers in Germany found lower HCSU with respect to primary care physicians and specialist outpatient physician services, whereas inpatient care was utilized more often [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Health Care Services Utilization and Health-Related Quality of Life of Syrian Refugees with Post-Traumatic Stress Symptoms in Germany (the Sanadak Trial)

Grochtdreis

Röhr

Jung

et al. 2021

IJERPH

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Refugees who have fled from the ongoing civil war in Syria that arrived in Germany often develop post-traumatic stress symptoms (PTSS). The aim of this study was to determine health care services utilization (HCSU), health care costs and health-related quality of life (HrQoL) of Syrian refugees with mild to moderate PTSS without current treatment in Germany. The study was based on the baseline sample of a randomized controlled trial of a self-help app for Syrian refugees with PTSS (n = 133). HCSU and HrQoL based on the EQ-5D-5L and its visual analogue scale (EQ-VAS) were assessed with standardized interviews. Annual health care costs were calculated using extrapolated four-month HCSU and standardized unit costs. Associations between health care costs, HrQoL and PTSS severity were examined using generalized linear models. Overall, 85.0% of the sample utilized health care services within four months. The mean total annual health care costs were EUR 1920 per person. PTSS severity was not associated with health care costs. The EQ-5D-5L index score and the EQ-VAS score was 0.82 and 73.6, respectively. For Syrian refugees with higher PTSS severity, the EQ-5D-5L index score was lower (−0.17; p < 0.001). The HCSU and the resulting health care costs of Syrian refugees with mild to moderate PTSS without current treatment are low and those with a higher PTSS severity had a lower HrQoL.

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Psychiatrische Behandlungskosten von Patientinnen mit Posttraumatischer Belastungsstörung nach sexuellem Missbrauch vor und nach stationärer DBT-PTSD

Cited by 9 publications

References 30 publications

Health-Related Quality of Life and Costs of Posttraumatic Stress Disorder in Adolescents and Young Adults in Germany

Health-Related Quality of Life and Costs of Posttraumatic Stress Disorder in Adolescents and Young Adults in Germany

A research programme to evaluate DBT-PTSD, a modular treatment approach for Complex PTSD after childhood abuse

Health Care Services Utilization and Health-Related Quality of Life of Syrian Refugees with Post-Traumatic Stress Symptoms in Germany (the Sanadak Trial)

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