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Effectiveness of a Low-Intensity Home-Based Aftercare for Patients with Severe Mental Disorders: A 12-month Randomized Controlled Study

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Abstract

To examine the effectiveness of a low-intensity home-based aftercare service, 130 patients with schizophrenia, schizoaffective disorder or bipolar disorder were randomized to receive either home aftercare or treatment-as-usual. In home aftercare, a general practitioner and a social worker made home visits once in a month after discharge from the hospital wherein they provided education and treatment. In a 1-year follow-up, home aftercare led to greater reduction in rehospitalization rate, more improvement in psychotic symptoms and global illness severity, as well as greater service satisfaction. The implementation of this low-intensity aftercare is recommended, especially in less resourceful settings.

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References

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington: American Psychiatric Association.

    Google Scholar 

  • Attkisson, C. C., & Zwick, R. (1982). The client satisfaction questionnaire. Psychometric properties and correlations with service utilization and psychotherapy outcome. Evaluation and Program Planning, 5(3), 233–237.

    Article  PubMed  CAS  Google Scholar 

  • Bergen, J., Hunt, G., Armitage, P., & Bashir, M. (1998). Six-month outcome following a relapse of schizophrenia. Australian and New Zealand Journal of Psychiatry, 32(6), 815–822.

    Article  PubMed  CAS  Google Scholar 

  • Burns, T., Beadsmoore, A., Bhat, A. V., Oliver, A., & Mathers, C. (1993). A controlled trial of home-based acute psychiatric services. I: Clinical and social outcome. British Journal of Psychiatry, 163, 49–54.

    Article  PubMed  CAS  Google Scholar 

  • Burns, T., Knapp, M., Catty, J., Healey, A., Henderson, J., Watt, H., et al. (2001). Home treatment for mental health problems: A systematic review. Health Technology Assessment, 5(15), 1–139.

    PubMed  CAS  Google Scholar 

  • Dieterich, M., Irving, C. B., Park, B., & Marshall, M. (2010). Intensive case management for severe mental illness. Cochrane Database Systematic Review, (10), CD007906.

  • Kampman, O., Illi, A., Poutanen, P., & Leinonen, E. (2003). Four-year outcome in non-compliant schizophrenia patients treated with or without home-based ambulatory outpatient care. European Psychiatry, 18(1), 1–5.

    Article  PubMed  CAS  Google Scholar 

  • Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261–276.

    PubMed  CAS  Google Scholar 

  • MacDonald, A. W., 3rd, Carter, C. S., Kerns, J. G., Ursu, S., Barch, D. M., Holmes, A. J., et al. (2005). Specificity of prefrontal dysfunction and context processing deficits to schizophrenia in never-medicated patients with first-episode psychosis. American Journal of Psychiatry, 162(3), 475–484.

    Article  PubMed  Google Scholar 

  • Malakouti, S. K., Nojomi, M., Panaghi, L., Chimeh, N., Mottaghipour, Y., Joghatai, M. T., et al. (2009). Case-management for patients with schizophrenia in Iran: A comparative study of the clinical outcomes of mental health workers and consumers’ family members as case managers. Community Mental Health Journal, 45(6), 447–452.

    Article  PubMed  Google Scholar 

  • Marshall, M., Gray, A., Lockwood, A., & Green, R. (2011). Case management for people with severe mental disorders. Cochrane Database Systematic Review, (4), CD000050.

  • Pai, S., & Roberts, E. J. (1983). Follow-up study of schizophrenic patients initially treated with home care. British Journal of Psychiatry, 143, 447–450.

    Article  PubMed  CAS  Google Scholar 

  • Pai, S., Channabasavanna, S. M., Nagarajaiah, A., & Raghuram, R. (1985). Home care for chronic mental illness in Bangalore: An experiment in the prevention of repeated hospitalization. British Journal of Psychiatry, 147, 175–179.

    Article  PubMed  CAS  Google Scholar 

  • Rosenheck, R. A., Neale, M. S., & Mohamed, S. (2010). Transition to low intensity case management in a VA assertive community treatment model program. Psychiatric Rehabilitation Journal, 33(4), 288–296.

    Article  Google Scholar 

  • Sellwood, W., Thomas, C. S., Tarrier, N., Jones, S., Clewes, J., James, A., et al. (1999). A randomised controlled trial of home-based rehabilitation versus outpatient-based rehabilitation for patients suffering from chronic schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 34(5), 250–253.

    Article  PubMed  CAS  Google Scholar 

  • Skevington, S. M., Lotfy, M., & O’Connell, K. A. (2004). The World Health Organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Quality of Life Research, 13(2), 299–310.

    Article  PubMed  CAS  Google Scholar 

  • Tyrer, P., Evans, K., Gandhi, N., Lamont, A., Harrison-Read, P., & Johnson, T. (1998). Randomised controlled trial of two models of care for discharged psychiatric patients. BMJ, 316(7125), 106–109.

    Article  PubMed  CAS  Google Scholar 

  • Wasylenki, D., Gehrs, M., Goering, P., & Toner, B. (1997). A home-based program for the treatment of acute psychosis. Community Mental Health Journal, 33(2), 151–162. discussion 163–155.

    Article  PubMed  CAS  Google Scholar 

  • Young, R. C., Biggs, J. T., Ziegler, V. E., & Meyer, D. A. (1978). A rating scale for mania: Reliability, validity and sensitivity. British Journal of Psychiatry, 133, 429–435.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

This study was supported by a grant from the Undersecretary of Research at Tehran University of Medical Sciences. We would like to thank Dr. Payam Sobhebidari, Dr. Alireza Manouchehri, Elham Miri, Faezeh Razmjoo, and Elnaz Moghaddasi for their kind contributions to the study.

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Correspondence to Vandad Sharifi.

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Sharifi, V., Tehranidoost, M., Yunesian, M. et al. Effectiveness of a Low-Intensity Home-Based Aftercare for Patients with Severe Mental Disorders: A 12-month Randomized Controlled Study. Community Ment Health J 48, 766–770 (2012). https://doi.org/10.1007/s10597-012-9516-z

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  • DOI: https://doi.org/10.1007/s10597-012-9516-z

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