跨诊断团体认知行为疗法在初级保健中治疗情绪障碍的成本效益
跨诊断团体认知行为疗法在初级保健中治疗情绪障碍的成本效益：一项基于PsicAP临床试验的分析
Cost-effectiveness of transdiagnostic group cognitive behavioral therapy for emotional disorders in primary care: An analysis of the PsicAP clinical trial
——《咨询与临床心理学杂志》第94卷，第2期，2026年2月——
【摘要】目的：跨诊断认知行为疗法已被证实是治疗情绪障碍的有效手段。然而，团体式跨诊断认知行为疗法的成本效益尚不明确。鉴于在资源有限的背景下，初级保健领域对心理护理的需求日益增长，对跨诊断团体认知行为疗法（TD-GCBT）进行经济学评价，将为治疗决策提供有价值的数据支持。目的：对 PsicAP 治疗方案进行经济学评价。方法：PsicAP-Costs是一项多中心、随机对照试验，共纳入429名疑似患有焦虑症、抑郁症和/或躯体形式障碍的患者。参与者被随机分配至常规治疗组（TAU [对照组]）或TD-GCBT加常规治疗组（TD-GCBT+TAU [实验组]）。治疗方案包括在12至14周的时间跨度内，进行7次TD-GCBT疗程。结果：TD-GCBT+TAU组的主要疗效指标显著优于对照组，在减轻抑郁、焦虑和躯体化症状方面，其效应量介于小至大之间。经济学评价结果显示，该疗法产生的平均增量效益为 0.06 个质量调整生命年（QALY），平均增量成本为263欧元。据此计算得出的增量成本效益比为每质量调整生命年4,759欧元。结论：将TD-GCBT整合至常规治疗（TAU）中，构成了一种具有成本效益的治疗策略。其每质量调整生命年4,759欧元的增量成本效益比，远低于西班牙公认的支付意愿阈值（该阈值范围为20,000至25,000欧元）。在此阈值下，该干预措施具有成本效益的概率很高，介于86%至89%之间。因此，在初级保健（PC）领域实施TD-GCBT，有望成为提升情绪障碍护理质量的一项具有成本效益的方案。
【关键词】情绪障碍，跨诊断认知行为疗法，成本分析，随机对照试验
[Abstract] Objective/s: Transdiagnostic cognitive behavioral therapy has proven to be an effective treatment for emotional disorders. However, the cost-effectiveness of group Transdiagnostic cognitive behavioral therapy remains unknown. Given the growing demand for psychological care in primary care in the context of limited resources, an economic evaluation of transdiagnostic group cognitive behavioral therapy (TD-GCBT) would provide valuable data for treatment decision making. Aims: To conduct an economic evaluation of the PsicAP treatment protocol. Method: The PsicAP-Costs was a multicenter, randomized controlled trial of 429 patients with a suspected diagnosis of anxiety, depression, and/or somatoform disorders. Participants were randomized to treatment as usual (TAU [control group] or TD-GCBT plus TAU [experimental group]). Treatment consisted of seven sessions of TD-GCBT delivered over a 12-14 week period. Results: The primary efficacy outcomes were significantly better in the TD-GCBT + TAU group, with small to large effect sizes for the reduction of depression, anxiety, and somatization symptoms. The economic evaluation yielded a mean incremental effectiveness of .06 quality-adjusted life years with a mean incremental cost of 263€. This resulted in an incremental cost-effectiveness ratio of 4,759€ per quality-adjusted life year. Conclusions: The integration of TD-GCBT into TAU represents a cost-effective therapeutic approach. The incremental cost-effectiveness ratio of 4,759€ per quality-adjusted life years is well below the willingness-to-pay threshold accepted in Spain, which ranges from 20,000€ to 25,000€. At this threshold, the probability that the intervention is cost-effective is high, ranging from 86% to 89%. Therefore, the implementation of TD-GCBT in PC may represent a cost-effective option for improving the quality of care for emotional disorders.
[Key words] emotional disorders, transdiagnostic cognitive behavioral therapy, cost analysis, randomized controlled trial
论文原文：Ruiz-Rodríguez, P., Mu?oz-Navarro, R., Esteller-Collado, G., et al. (2026). Cost-effectiveness of transdiagnostic group cognitive behavioral therapy for emotional disorders in primary care: An analysis of the PsicAP clinical trial. Journal of Consulting and Clinical Psychology, Volume 94, Issue 2, Pages 101–113. February 2026.
https://doi.org/10.1037/ccp0000990
（翻译兼责任编辑：MARY）
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