[Efficacy and associated costs of an outpatient intervention in women with severe depression and early trauma].

BACKGROUND A high proportion of women consulting for depression have a history of childhood abuse and trauma. AIM To compare the efficacy and costs associated with a treatment that enquires directly into childhood trauma and understands present interpersonal difficulties as a compulsion to repeat the traumatic past, versus the usual treatment, in women with severe depression and childhood trauma. MATERIAL AND METHODS Eighty seven women with depression and prior history of early trauma that sought help at the Mental Health Unit of the Hospital de Curicó were studied. Forty four were randomly assigned to the experimental treatment, and 43 to the usual management. Patients were evaluated using the Hamilton Depression Scale, the Outcome Questionnaire (OQ 45.2) and an expenditures sheet at baseline, three and six months. An intention to treat analysis and a simple cost-analysis were performed. RESULTS Hamilton and OQ 45.2 scores improved in both treatment groups, with significantly better results achieved in the experimental patients. The direct overall costs of experimental and control treatments were CLP 8,628,587 and 9,688,240, respectively. The main contributors to costs in both arms were medications (26.5%), followed by the number of psychiatric consultations (19.2%) in the experimental group and by hospitalizations (25.4%) in the control group. The costs per patient recovered in experimental and control groups were CLP 616,328 and 1,973,649, respectively. CONCLUSIONS The proposed model resulted more effective for the treatment of this group of women.