doi:10.1007/s12671-024-02319-4engD’Amico, FrancescoNavarrete, JaimeMontero-Marín, JesúsCardeñosa-Valera, EugeniaNavarro-Gil, MaytePérez-Aranda, AdriánLópez-del-Hoyo, YolandaCollado-Navarro, CarlosGarcía-Campayo, JavierLuciano, Juan V.Cost-Utility of Attachment-Based Compassion Therapy (ABCT) and Mindfulness-Based Stress Reduction (MBSR) in the Management of Depressive, Anxious, and Adjustment Disorders in Mental Health Settings: Economic Evaluation Alongside a Randomized Controlled TrialART-2024-138177Objectives: The main objective of this paper was to examine the cost-utility of attachment-based compassion therapy (ABCT) compared to Mindfulness-Based Stress Reduction (MBSR) and treatment-as-usual (TAU) on patients with depressive and/or anxious disorder, or adjustment disorder with depressive and/or anxious symptomatology in terms of effects on quality-adjusted life years (QALYs) as well as healthcare costs from a public healthcare system perspective. Method: A 6-month randomized controlled trial was conducted. Ninety Spanish patients with mental disorders (depressive, anxious, or adjustment disorders) received 8 weekly group sessions of TAU + ABCT, TAU + MBSR, or TAU alone. Data collection took place at pre- and 6-month follow-up. Cost-utility of the two treatment groups (ABCT vs MBSR vs TAU) was compared by examining treatment outcomes in terms of QALYs (obtained with the EQ-5D-3L) and healthcare costs (data about service use obtained with the Client Service Receipt Inventory). Results: Both MBSR and ABCT were more efficient than TAU alone, although the results did not reach statistical significance. Compared to ABCT, MBSR produced an increase both in terms of costs (€53.69, 95% CI [− 571.27 to 513.14]) and effects (0.004 QALYs, 95% CI [− 0.031 to 0.049]); ICUR = €13,422.50/QALY). Both interventions significantly reduced the number of visits to general practice compared to TAU. Conclusions: This study has contributed to the evidence base of mindfulness- and compassion-based programs and provided promising information about the cost-utility of MBSR for patients with emotional disorders. However, the small sample size and short follow-up period limit the generalizability of the findings. Preregistration Clinicaltrials.gov; NCT034254872024http://zaguan.unizar.es/record/13463910.1007/s12671-024-02319-4http://zaguan.unizar.es/record/134639oai:zaguan.unizar.es:134639info:eu-repo/grantAgreement/ES/ISCIII/CIBERESP/CB22-02-00052info:eu-repo/grantAgreement/ES/ISCIII/CP21-00080info:eu-repo/grantAgreement/ES/ISCIII-RICAPPS/RD21-0016-0005Mindfulness 15, 3 (2024), 11 pp.byhttps://creativecommons.org/licenses/by/4.0/deed.esinfo:eu-repo/semantics/openAccess