Attitudinal barriers, such as low perceived need or a stigma-related desire to handle one’s problems seems to be more important than structural barriers, such as availability of treatment and expenses both for initiating and continuing treatment 15. However, costs are expected to double by 2030 10 because of increasing demand and rising costs.ĭespite the availability of effective psychological interventions 12, the majority of individuals with MDs remain untreated 13 or receive delayed treatment often initiated several years after MD onset 14. In the EU, MD-associated costs are estimated at €798 billion in 2010 11. Indirect costs, such as productivity losses or premature death, were twice as high as direct medical costs related to health service use. In 2010, the global costs associated with MDs were estimated at US$2.5 trillion 10. Associated productivity losses due to absenteeism and presenteeism, earlier retirement, and increased level of healthcare utilization have major influence on society. MDs are associated with substantial economic costs for society. Hence, the burden of MDs is comparable with those of cardiovascular and circulatory diseases 9. argued that the “true” estimate of the global burden caused by MDs will double compared with earlier estimates and will account for 13% of total DALYs. According to the World Health Organization, disease burden as expressed in disability-adjusted life years (DALYs) associated with MDs is substantial and has remained constant over time and across countries 8. In addition, MDs appear to be correlated with several physical illnesses 6 such as stroke, pain, cancer, diabetes mellitus, asthma, heart disease, hypertension, and insomnia 7. Meta-analytic evidence shows an elevated risk of mortality in people with MDs 3, 4 and low quality of life 5. MDs constitute a substantial burden for individuals and society. Globally, every fifth person is affected, and roughly one-third of adults have experienced mental illness at least once 2. Mental disorders (MDs) are highly prevalent worldwide 1. Trial registration: PROSPERO Registration No. However, more research is needed into unguided (preventive) IMIs with active control conditions (e.g., treatment as usual) and longer time horizon across a wider range of disorders. IMIs for anxiety and depression have potential to be cost-effective. Heterogeneity across studies was high because of factors such as different costing methods, design, comparison groups, and outcomes used. The quality of most evaluations was good, albeit with some risks of bias. Guided IMIs were likely to be cost-effective in depression and anxiety. Of the 4044 studies, 36 economic evaluations were reviewed. Cost-effectiveness was assumed at or below £30,000 per quality-adjusted life year gained. Methodological quality and risk of bias were assessed. Electronic databases (including MEDLINE, PsycINFO, CENTRAL, PSYNDEX, and NHS Economic Evaluations Database) were searched for randomized controlled trials examining IMIs targeting mental disorders and symptoms and conducting a full health economic evaluation. A systematic search was conducted for trial-based economic evaluations published before 10th May 2021. This review aimed to provide an overview of the cost-effectiveness of IMIs for mental disorders and symptoms. In view of the staggering disease and economic burden of mental disorders, internet and mobile-based interventions (IMIs) targeting mental disorders have often been touted to be cost-effective however, available evidence is inconclusive and outdated.
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