@article{ikic_reduction_2017,

title = {Reduction in costs after treating comorbid panic disorder with agoraphobia and generalized anxiety disorder},

author = {V. Ikic and C. Bélanger and S. Bouchard and P. Gosselin and F. Langlois and J. Labrecque and M. J. Dugas and A. Marchand},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85018690998&partnerID=40&md5=0d0600e6dd4e2a381f733ac063d639dc},

issn = {10914358},

year  = {2017},

date = {2017-01-01},

journal = {Journal of Mental Health Policy and Economics},

volume = {20},

number = {1},

pages = {11–20},

abstract = {Background: Panic disorder with agoraphobia (PDA) and generalized anxiety disorder (GAD) are impairing and costly disorders that are often misdiagnosed and left untreated despite multiple consultations. These disorders frequently co-occur, but little is known about the costs associated with their comorbidity and the impact of cognitive-behavioral therapy (CBT) on cost reduction. Aims of the Study: The first objective of this study was to assess the mental health-related costs associated with the specific concomitance of PDA and GAD. The second aim was to determine whether there is a reduction in direct and indirect mental healthrelated costs following conventional CBT for the primary disorder only (PDA or GAD) or combined CBT adapted to the comorbidity (PDA and GAD). Methods: A total of 123 participants with a double diagnosis of PDA and GAD participated in this study. Direct and indirect mental health-related costs were assessed and calculated from a societal perspective at the pre-Test, the post-Test, and the three-month, sixmonth and one-year follow-ups. Results: At the pre-Test, PDA-GAD comorbidity was found to generate a mean total cost of CAD2,000.48 (SD = 2,069.62) per participant over a three-month period. The indirect costs were much higher than the direct costs. Both treatment modalities led to significant and similar decreases in all cost categories from the pretest to the post-Test. This reduction was maintained until the oneyear follow-up. Discussion: Methodological choices may have underestimated cost evaluations. Nonetheless, this study supports the cost offset effects of both conventional CBT for primary PDA or GAD and combined CBT for PDA-GAD comorbidity. Implications for Healthcare Provision and Use: Treatment of comorbid and costly disorders with evidence-based treatments such as CBT may lead to considerable economic benefits for society. Implications for Health Policies: Considering the limited resources of healthcare systems, it is important to make choices that will lead to better accessibility of quality services. The application of CBT for PDA, GAD or both disorders and training mental health professionals in this therapeutic approach should be encouraged. Additionally, it would be favorable for insurance plans to reimburse employees for expenses associated with psychological treatment for anxiety disorders. Implications for Further Research: In addition to symptom reduction, it would be of great pertinence to explore which factors can contribute to reducing direct and indirect mental health-related costs. © 2017 ICMPE.},

note = {Publisher: ICMPE},

keywords = {adult, agoraphobia, Anxiety disorder, Anxiety Disorders, article, cognitive behavioral therapy, cognitive therapy, comorbidity, controlled study, dysthymia, economics, female, follow up, generalized anxiety disorder, health care cost, Health Care Costs, human, Humans, major clinical study, major depression, male, Mental health, obsessive compulsive disorder, panic, Panic Disorder, phobia, posttraumatic stress disorder, procedures, Quebec, social phobia, statistics and numerical data},

pubstate = {published},

tppubtype = {article}

}

@article{robillard_development_2011,

title = {The development of the SWEAT questionnaire: a scale measuring costs and efforts inherent to conducting exposure sessions.},

author = {G. Robillard and S. Bouchard and S. Dumoulin and T. Guitard},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-80054121010&partnerID=40&md5=10bd1de5d9c38b5a975dab3b477c1d4d},

issn = {09269630},

year  = {2011},

date = {2011-01-01},

journal = {Studies in health technology and informatics},

volume = {167},

pages = {105–110},

abstract = {For decades, empirical studies have shown the effectiveness of exposure techniques when used in cognitive-behavioral therapy (CBT) treatment for anxiety disorders. A few studies are now suggesting that using Virtual Reality (VR) may be an effective way to conduct exposure and overcome some of the limitations of in vivo exposure. The aim of this study is to validate the Specific Work for Exposure Applied in Therapy (SWEAT) questionnaire that measures costs and efforts required to conduct in vivo and in virtuo exposure. A total of 265 exposure sessions (in vivo = 140; in virtuo = 125) were rated by experienced psychologists. Reliability analysis revealed three main factors in the construct of the SWEAT questionnaire. Results also showed that conducting exposure in VR is less of a burden and more readily adapted to the patients' needs than in vivo.},

keywords = {adult, Anxiety disorder, Anxiety Disorders, article, behavior therapy, clinical effectiveness, computer assisted therapy, computer interface, Computer Simulation, Computer-Assisted, controlled study, cost benefit analysis, economics, exposure, female, human, Humans, Implosive Therapy, in vivo study, male, methodology, psychologist, Psychometrics, psychometry, questionnaire, Questionnaires, reliability, reproducibility, Reproducibility of Results, specific work for exposure applied in therapy questionnaire, Therapy, User-Computer Interface, virtual reality},

pubstate = {published},

tppubtype = {article}

}