{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:57:39Z","timestamp":1792612659441,"version":"4.5.0"},"reference-count":0,"publisher":"Cambridge University Press (CUP)","issue":"6","license":[{"start":{"date-parts":[[2003,7,31]],"date-time":"2003-07-31T00:00:00Z","timestamp":1059609600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2003,9]]},"abstract":"<jats:p><jats:bold>Background.<\/jats:bold> Deliberate self-harm can be costly, in terms of treatment and subsequent suicide. Any intervention that reduces episodes of self-harm might therefore have a major impact on the costs incurred by service providers and the productivity losses due to illness or premature death.<\/jats:p><jats:p><jats:bold>Method.<\/jats:bold> Four hundred and eighty patients with a history of recurrent deliberate self-harm were randomized to manual-assisted cognitive behaviour therapy (MACT) or treatment as usual. Economic data were collected from patients at baseline, 6 and 12 months, and these data were complete for 397 patients. Incremental cost-effectiveness was explored using the primary outcome measure, proportion of patients having a repeat episode of deliberate self-harm, and quality of life. The uncertainty surrounding costs and effects was represented using cost-effectiveness acceptability curves.<\/jats:p><jats:p><jats:bold>Results.<\/jats:bold> Differences in total cost per patient were statistically significant at 6 months in favour of MACT (\u2212\u00a3897, 95% CI \u22121747 to \u221248, <jats:italic>P<\/jats:italic>=0\u00b704), but these differences did not remain significant at 12 months (\u2212\u00a3838, 95% CI \u22122142 to 466, <jats:italic>P<\/jats:italic>=0\u00b721). Nevertheless, exploration of the uncertainty surrounding these estimates suggests there is &gt;90% probability that MACT is a more cost-effective strategy for reducing the recurrence of deliberate self-harm in this population over 1 year than treatment as usual. The results for quality of life were not conclusive.<\/jats:p><jats:p><jats:bold>Conclusion.<\/jats:bold> Cost-effectiveness acceptability curves demonstrate that, based on the evidence currently available, to reject MACT on traditional grounds of statistical significance and to continue funding current practice has &lt;10% chance of being the correct decision in terms of cost-effectiveness.<\/jats:p>","DOI":"10.1017\/s0033291703008183","type":"journal-article","created":{"date-parts":[[2004,7,12]],"date-time":"2004-07-12T06:14:05Z","timestamp":1089612845000},"page":"977-986","source":"Crossref","is-referenced-by-count":65,"title":["Cost-effectiveness of brief cognitive behaviour therapy <i>versus<\/i> treatment as usual in recurrent deliberate self-harm: a decision-making approach"],"prefix":"10.1017","volume":"33","author":[{"given":"S.","family":"BYFORD","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"KNAPP","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"GREENSHIELDS","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O. C.","family":"UKOUMUNNE","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"JONES","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"THOMPSON","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"TYRER","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"SCHMIDT","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"DAVIDSON","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"( POPMACT GROUP)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2003,7,31]]},"container-title":["Psychological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0033291703008183","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,11]],"date-time":"2019-04-11T15:29:40Z","timestamp":1554996580000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0033291703008183\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,7,31]]},"references-count":0,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2003,9]]}},"alternative-id":["S0033291703008183"],"URL":"https:\/\/doi.org\/10.1017\/s0033291703008183","relation":{},"ISSN":["0033-2917","1469-8978"],"issn-type":[{"value":"0033-2917","type":"print"},{"value":"1469-8978","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,7,31]]}}}