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Schema therapy cost-effective for personality disorders

Recent findings indicate cost-effectiveness of schema therapy, but not clarification-oriented psychotherapy, for personality disorders.

To compare cost-effectiveness and cost-utility of schema therapy, clarification-oriented psychotherapy and treatment as usual for individuals with avoidant, dependent, obsessive-compulsive, paranoid, histrionic and/or narcissistic personality disorder from a societal perspective, Lotte L. M. Bamelis, PhD, of Maastricht University, the Netherlands, and colleagues conducted a multicenter, randomized controlled trial between May 2006 and December 2011. They randomly assigned 320 individuals, diagnosed with DSM-IV personality disorders, to received schema therapy (n = 145), treatment as usual (n = 134) or clarification-oriented psychotherapy (n = 41). Costs were measured by interview and patient registries over 36 months. The proportion of recovered patients was measured with the Structured Clinical Interview for DSM-IV Axis II Personality Disorders.

Schema therapy was dominant over treatment as usual and clarification-oriented psychotherapy due to greater clinical efficacy and lower costs, according to researchers.

Treatment as usual was more cost-effective than clarification-oriented psychotherapy due to lower costs.

In cost-utility analyses, schema therapy had a stable 75% probability of being cost-effective, the researchers reported. These findings were confirmed by sensitivity analyses.

As a result, the researchers concluded that cost-effectiveness of schema therapy was supported by their analyses, however, cost-effectiveness of clarification-oriented psychotherapy was not.  – by Amanda Oldt

Disclosure: Please see the full study for a list of all authors’ relevant financial disclosures.