How was cognitive behavioural therapy for mood disorder implemented in Japan? A retrospective observational study using the nationwide claims database from FY2010 to FY2015

Abstract

Objectives: To clarify the dissemination status of cognitive behavioural therapy (CBT) in Japan under the national health insurance scheme.

Design: Retrospective observational study.

Setting: National Database of Health Insurance Claims and Specific Health Checkups of Japan.

Participants: Patients who received CBT under the national health insurance scheme from fiscal years (FY) 2010 to 2015.

Primary and secondary outcome measures: We estimated the change rate and the standardised claim ratio (SCR) for the number of patients receiving CBT and analysed the association between the CBT status and several regional factors.

Results: We found that (a) a total of 60 304 patients received CBT during the study period; (b) the number of patients receiving CBT was highest in the first year (-1.8% from FY2010 to FY2015); (c) the number of patients who received CBT per 100 000 population decreased (or remained at zero) in most prefectures (32 out of 47); (d) there was a maximum 424.7-fold difference between prefectures in the standardised claim ratio for CBT and (e) the number of registered CBT institutions was significantly associated with the number of patients who received CBT.

Conclusions: The provision of CBT did not increase in the first 6 years (FY2010-2015) after its coverage in Japan's national health insurance scheme. Further studies including a questionnaire survey of registered CBT institutions are required to get more detailed information on the dissemination of CBT in Japan.

Keywords: Japan; cognitive behavioral therapy; database; mental health; national health insurance.