A cost-utility analysis of psychoanalysis versus psychoanalytic psychotherapy

Caspar C Berghout, D.J. Zevalkink, Leona Hakkaart-Van Roijen

Research output: Contribution to JournalArticleAcademicpeer-review


OBJECTIVES: Despite the considerable and growing body of research about the clinical effectiveness of long-term psychoanalytic treatment, relatively little attention has been paid to economic evaluations, particularly with reference to the broader range of societal effects. In this cost-utility study, we examined the incremental cost-effectiveness ratio (ICER) of psychoanalysis versus psychoanalytic psychotherapy.

METHODS: Incremental costs and effects were estimated by means of cross-sectional measurements in a cohort design (psychoanalysis, n = 78; psychoanalytic psychotherapy, n = 104). Quality-adjusted life-years (QALYs) were estimated for each treatment strategy using the SF-6D. Total costs were calculated from a societal perspective (treatment costs plus other societal costs) and discounted at 4 percent. Psychoanalysis was more costly than psychoanalytic psychotherapy, but also more effective from a health-related quality of life perspective. The ICER--that is, the extra costs to gain one additional QALY by delivering psychoanalysis instead of psychoanalytic psychotherapy--was estimated at 52,384 euros per QALY gained.

CONCLUSIONS: Our findings show that the cost-utility ratio of psychoanalysis relative to psychoanalytic psychotherapy is within an acceptable range. More research is needed to find out whether cost-utility ratios vary with different types of patients. We also encourage cost-utility analyses comparing psychoanalytic treatment to other forms of (long-term) treatment.

Original languageEnglish
Pages (from-to)3-10
Number of pages8
JournalInternational Journal of Technology Assessessment in Health Care
Issue number1
Publication statusPublished - Jan 2010


  • Adult
  • Age Factors
  • Cohort Studies
  • Cost of Illness
  • Cost-Benefit Analysis
  • Cross-Sectional Studies
  • Depressive Disorder
  • Female
  • Humans
  • Male
  • Personality Disorders
  • Psychoanalysis
  • Psychoanalytic Therapy
  • Quality of Life
  • Quality-Adjusted Life Years
  • Sex Factors
  • Socioeconomic Factors
  • Time Factors
  • Clinical Trial
  • Journal Article
  • Multicenter Study
  • Research Support, Non-U.S. Gov't


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