Two-stage integrated care versus antipsychotic medication alone on outcomes of schizophrenia: One-year randomized controlled trial and follow-up. (August 2017)

• Record Type: Journal Article
• Authors: She, Shenglin; Deng, Yongjie; Chen, Yuwei; Wu, Chao; Yi, Wenying; Lu, Xiaodan; Chen, Xinrui; Li, Juanhua; Li, Ruikeng; Zhang, Jie; Xiao, Di; Wu, Haibo; Ning, Yuping; Zheng, Yingjun
• Is Part Of: Psychiatry research. Volume 254(2017)
• Page Start: 164
• Page End: 172
• Publication Date: 2017-08
• Subjects: Cognitive behavior therapy -- Rehabilitation -- Case management; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2017.04.054
• Languages: English
• ISSNs: 0165-1781

Abstract

Abstract: Integrated care can reduce rate of relapse and improve personal and social functions in patients with schizophrenia. We established and evaluated a new model of "intensive-consolidation" two-stage integrated care (IC) for inpatients with schizophrenia. Data were collected between 2012 and 2015. Chinese inpatients with schizophrenia (n=170) diagnosed according to DSM-IV were randomly assigned to antipsychotic medication-alone (n=84) or two-stage IC (n=86) and followed up for 12 months. The IC model included intensive treatments (antipsychotics plus the cognitive behavior therapy and rehabilitation treatment) during hospitalization and 3-time consolidation treatments with 3-month intervals at clinics. Outcome measures included the rate of relapse, psychiatric symptoms and social functioning. Compared with medication-alone group, the rate of relapse were significantly lower in IC group ( p =0.012); the Mixed-Effects Model for Repeated-Measures analyses showed that the IC group significantly improved in positive symptoms over time; greater improvement in self-care and less aggressive behaviors were observed over time in IC group (all p <0.008). The findings support the feasibility and effectiveness of the new two-stage model of integrated care as an intervention for middle-acute-phase inpatients with schizophrenia. The model is particularly informative to countries where medical resources are mainly distributed in developed regions. Highlights: The integrated model contains two stages: hospitalization and following clinic. The two-stage care integrated model was practical and efficient for schizophrenia.