Nick Verhaeghe

Objectives: Obesity and overweight pose a global health and economic burden. Lifestyle interventions are recommended as first‐line treatment. Given their individual complexity, personalized lifestyle interventions may be more effective than one‐size‐fits‐all approaches. This review assessed the methodology, findings and reporting quality of cost‐effectiveness analyses evaluating personalized lifestyle interventions in adults with overweight or obesity. Methods: MEDLINE, Embase, Web of Science, and Scopus were searched in March 2025, with backward reference tracking. Full economic evaluations were included without date restrictions. Studies were categorized by highest applicable personalization level: behavioral (Level 1), phenotype‐based (Level 2), or omics‐based (Level 3). Reporting quality was assessed using the CHEERS 2022 Checklist. Results: From 15,385 records screened, 18 studies were included. Fourteen evaluated Level 1 interventions and two each evaluated Levels 2 and 3. Thirteen were cost‐utility analyses: seven reported cost‐effective or dominant findings, four reported not cost‐effective findings, and two reported unclear or mixed results. Ten studies reported cost‐effectiveness using clinical outcomes: eight showed favorable findings for at least one outcome, and two reported unclear findings. Heterogeneity in intervention design and methods between studies precluded robust conclusions. Findings for level 1 were mixed, evidence for levels 2 and 3 was limited, with favorable and inconsistent findings, respectively. Conclusions: Evidence on the cost‐effectiveness of personalized lifestyle interventions was mixed and predominantly behavioral personalization. The scarcity of economic evaluations evaluating more advanced personalized lifestyle interventions remains a key evidence gap. Future research should evaluate their added value to inform resource allocation in obesity management.

Effective communication is fundamental to high-quality healthcare. Language barriers between clinicians and patients are associated with miscommunication, negatively impacting patient and physician...

BackgroundDepression is a highly recurrent condition, and many individuals remain vulnerable to relapse during the remission phase. Cognitive Control Training (CCT), particularly the internet-delivered adaptive Paced Auditory Serial Addition Task (aPASAT), has shown promise in preventing relapse, yet its health economic value has not been evaluated. This study assessed the cost-utility of adding aPASAT to treatment as usual (TAU) for adults in remission from major depressive disorder (MDD).MethodsA Markov state-transition model simulated a hypothetical cohort of Belgian adults aged 18-65 years in remission from MDD over a five-year time horizon from a healthcare payer perspective. Model parameters were mainly derived from published literature. Outcomes included incremental costs, incremental quality-adjusted life years (QALYs), incremental cost-effectiveness ratios (ICERs), and incremental monetary benefit (INMB). Uncertainty was evaluated using one-way sensitivity, two-way sensitivity and probabilistic sensitivity analysis (5,000 simulations), and multiple deterministic scenario analyses.ResultsIn the base case, aPASAT + TAU dominated TAU alone, yielding additional QALYs (Δ = 2192) and lower healthcare costs (Δ = –€77.38M), resulting in an INMB of €182.6M at a €48,000 per QALY threshold. Probabilistic sensitivity analysis indicated a 99.9% probability of cost-effectiveness. Scenario analyses varying adherence, coverage, remission prevalence, and time horizon consistently confirmed cost savings and improved health outcomes.ConclusionInternet-delivered CCT using the aPASAT appears to be a cost-effective strategy for preventing MDD relapse. Its low-cost and fully unguided format supports scalable integration into stepped, prevention-oriented mental healthcare systems.

BackgroundAlthough major depressive disorder (MDD) is known to have a high societal burden, little is known about the costs associated with the remission phase. Many individuals in remission experience residual symptoms that may impact functioning, productivity, and healthcare use. This study aimed to estimate the societal cost of individuals in remission from MDD in Belgium.MethodsA total of 138 adults in remission from MDD completed questionnaires assessing healthcare use (iMCQ) and productivity loss (WPAI:GH) over the past three months. Unit costs were applied to estimate annual costs. Descriptive analyses with bias-corrected bootstrap intervals were used. Generalized linear models with a log-link function and Tweedie distribution examined predictors of total, direct and indirect costs.ResultsMean annual societal cost per person was €5388.43 (BCa 95% CI: €3563–8875.05), including €1767.84 (BCa 95% CI: 1148.18–3927.78) in direct costs and €3620.59 (BCa 95% CI: €2142.32–6581.60) in indirect costs. In the final model predicting total societal costs, older age was associated with higher costs (+4.50% per year, p = .001). Sex and education were not significant predictors. Remission duration over 12 months was linked to lower total costs (–67.95%, p = .01) compared to less than 6 months.ConclusionsRemission from MDD continues to impose substantial societal costs, mostly due to reduced work participation. These findings highlight that remission does not equate to full recovery, emphasizing the need for future research into the cost-effectiveness of maintenance and relapse prevention strategies in remitted depression

Background:Cognitive control deficits that persist following remission from depression are known to increase the risk of relapse. Cognitive Control Training (CCT) has shown promise in improving these impairments, but is typically delivered according to a fixed schedule, irrespective of individual symptom trajectories. This study examined whether delivering just-in-time CCT booster sessions, tailored to personal depressive symptom patterns, could enhance outcomes.Methods:In a randomized controlled trial, 138 remitted depressed individuals first completed a 10-session fixed CCT schedule. Following this, participants were randomly assigned to either a booster group receiving just-in-time CCT booster sessions or a control group receiving no additional training. Outcome measures included depressive symptoms (PHQ-9) as the primary outcome, and secondary outcomes such as repetitive negative thinking, maladaptive and adaptive emotion regulation strategies, and cognitive control. Linear mixed-effects models were used to assess changes over time and group differences.Results:There were no significant clinical effects of adding just-in-time booster sessions compared to the control condition. Conclusions: Although no significant clinical or cognitive effects were observed, this study offers an innovative framework for adapting cognitive training delivery based on personal depression trajectories. The findings may inform the development of future personalized prevention strategies in depression care.Trial registration:This trial was registered at ClinicalTrials.gov (NCT05557760). The trial was prospectively registered prior to enrollment of the first participant.

Keratinocyte carcinoma (KC) represents 90% of all skin cancers and despite its relatively low mortality, may affect patients' health-related quality of life (HRQoL). This Belgian/Dutch cross-sectional study measured the impact of KC on HRQoL using generic instruments and a disease-specific questionnaire. HRQoL was measured using the disease-specific Basal and Squamous Cell Carcinoma Quality of Life (BaSQoL) questionnaire, consisting of five domains. Sub-scores range from 0 to 3, with a higher score meaning higher impact on HRQoL. Additionally, the generic instruments EuroQol 5-Dimension 5-level (EQ-5D-5 L), visual analog scale (VAS), 15-dimensions (15D) and the time trade-off (TTO) technique were employed. Scores range from 0 to 1, with 0 meaning death and 1 meaning perfect health. HRQoL scores were stratified by patients with single and multiple KC. Generalized linear models assessed differences in mean HRQoL scores across KC groups, adjusting for relevant covariates. The study included 715 patients; 332 with single KC and 383 with multiple KC. The BaSQoL subscores for single and multiple KC patients ranged from 0.44 to 0.52 for the 'appearance' subdomain to 1.16 and 1.27 for the 'other people' subdomain, indicating a low-to-moderate impact on HRQoL. Patients with multiple KC showed significantly higher impact on BaSQoL 'worries' subdomain (p = 0.002) and worse perceived health on the EQ-5D-5 L (p = 0.004) compared to patients with single KC. No significant differences were observed in VAS, 15D or TTO between single and multiple KC. Findings suggest, both with disease-specific and generic instruments, a moderate to low impact of KC on HRQoL.

Objective: Cognitive control impairments are frequently observed after remission from depression. There is evidence to show that cognitive control training (CCT) can reduce such impairments and related risk for recurrent episodes. However, it is currently unclear how many CCT sessions are required for short- and long-term effects. Method: This randomized controlled trial investigates the dose-response relationship of CCT in a sample of individuals with remitted depression (n = 216). Participants were randomly assigned to one of six arms, each receiving a different amount of training sessions (zero, one, five, 10, 15, or 20 sessions) over the course of 4 weeks, with each session lasting 15 min. Depressive symptoms and other cognitive and emotional transfer effects were examined shortly after training, as well as at 3- and 6-month follow-up. Results: We found task-specific, but no near cognitive transfer. Mixed-effects models showed that a minimum of 10 training sessions was required for a significant decrease in depressive symptoms shortly after training with medium effect sizes, but this was not maintained at 3- or 6-month follow-up. We observed reductions in perseverative thinking in all groups receiving 10 or more CCT sessions, which remained present until 6-month follow-up. Conclusions: A minimum of 10 CCT sessions is required for beneficial effects on depressive symptoms and perseverative thinking. Where perseverative thinking remained decreased long-term, this was not the case for depressive symptoms, indicating the need for continued training or the use of booster sessions to maintain training-related improvement. (PsycInfo Database Record (c) 2025 APA, all rights reserved).