Search results for ‘Subject term:"mental health problems"’ Sort:
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Outcomes of crises before and after introduction of a crisis resolution team
- Authors:
- JOHNSON Sonia, et al
- Journal article citation:
- British Journal of Psychiatry, 187(1), July 2005, pp.68-75.
- Publisher:
- Cambridge University Press
Crisis resolution teams (CRTs) are being introduced throughout England, but their evidence base is limited. The aim was to compare outcomes of crises before and after introduction of a CRT. A new methodology was developed for identification and operational definition of crises. A quasi-experimental design was used to compare cohorts presenting just before and just after a CRT was established. Following introduction of the CRT, the admission rate in the 6 weeks after a crisis fell from 71% to 49% (OR 0.38, 95% CI 0.21-0.70). A difference of 5.6 points (95% CI 2.0-8.3) on mean Client Satisfaction Questionnaire (CSQ-8) score favoured the CRT. These findings remained significant after adjustment for baseline differences. No clear difference emerged in involuntary hospitalisations, symptoms, social functioning or quality of life. CRTs may prevent some admissions and patients prefer them, although other outcomes appear unchanged in the short term.
Childhood sexual abuse, social support, and psychological outcomes: a loss framework
- Authors:
- MURTHI Meera, ESPELAGE Dorothy L.
- Journal article citation:
- Child Abuse and Neglect, 29(11), November 2005, pp.1215-1231.
- Publisher:
- Elsevier
The objectives of the study were: (a) to develop a scale to assess Childhood sexual abuse (CSA)related loss among a college sample of CSA survivors (CSALM), (b) to examine the measure's convergent validity through associations among depression, alexithymia, coping, and social support, and (c) to test whether social support moderates the relation between multiple experiences of CSA and loss. The study involved a survey methodology and included 116 college-age women reporting CSA experiences. Based on the Sexual Victimization Questionnaire, 90% of the sample reported CSA before age of 12, 12.3% reported CSA before age 12 with an adult over 16, and 42.2% reported CSA after age 12 with an adult. Exploratory Factor Analysis of the CSALM revealed a three-factor solution: (a) Loss of Optimism, (b) Loss of Self, and (c) Loss of Childhood. Convergent validity of several scales was evidenced through associations with depression, alexithymia, coping, and social support. Social support from family and friends was found to moderate the association between CSA experiences and loss dimensions. Findings provide preliminary psychometric support for the CSALM, a tool that will be useful in future investigations of loss among college-age CSA survivors. Findings also support using a loss framework to understand the current mental health of these survivors.
Desirable outcomes of of WORKSTEP: user and provider views
- Authors:
- MEAH Angela, THORNTON Patricia
- Publisher:
- Great Britain. Department for Work and Pensions
- Publication year:
- 2005
- Pagination:
- 110p.
- Place of publication:
- London
In this report disabled people said it was important to set themselves goals and experience achieving them. Achieving things through their jobs, they said, encouraged them to set goals outside work, like learning to travel independently or to drive. Going to work gave disabled people the chance to meet new people and make friends. This was especially important to people with learning disabilities who complained of feeling bored when ‘stuck at home’. The routine of work was important to people with mental health conditions. They said it offered a distraction from their condition and gave them a sense of an ‘ordinary life’. Disabled people said that having a job was a sign of ‘wellness’ and getting on with life.
Effect of psychiatric disorders on outcome of cognitive-behavioural therapy for chronic fatigue syndrome
- Authors:
- PRINS Judith, et al
- Journal article citation:
- British Journal of Psychiatry, 187(2), August 2005, pp.184-185.
- Publisher:
- Cambridge University Press
Psychiatric disorders have been associated with poor outcome in individuals with chronic fatigue syndrome (CFS). This Dutch study examines the impact of psychiatric disorders on outcome of cognitive-behavioural therapy (CBT). Psychiatric diagnoses were assessed with a structured psychiatric interview in a CBT trial of 270 people with CFS. Lifetime and current psychiatric disorders were found in 50 and 32% respectively. No significant differences in fatigue severity and functional impairment following treatment were found between participants with and without psychiatric diagnoses.
Person-related predictors of employment outcomes after participation in psychiatric vocational rehabilitation programmes: a systematic review
- Authors:
- MICHON Harry W. C., et al
- Journal article citation:
- Social Psychiatry and Psychiatric Epidemiology, 40(5), May 2005, pp.408-416.
- Publisher:
- Steinkopff
Although the importance of psychiatric vocational rehabilitation (PVR) programmes in helping those with severe mental illness to find and keep jobs is increasingly accepted, relatively little is known about the factors affecting PVR outcomes. This review covers eight studies (reported in 16 publications) using multivariate analysis of longitudinal data, which analysed employment outcomes after at least six months’ participation, and which analysed at least three predictor domains. Positive employment outcomes were related to better work performance during PVR participation, better self-efficacy and, to a lesser extent, better social functioning during PVR participation. Contrary to the findings of previous reviews, the influence of past functioning (such as work history and psychiatric history) is outweighed by past performance in PVR. Further, more rigorous, research is called for.
Maximizing treatment effectiveness in clinical practice: an outcome-informed, collaborative approach
- Author:
- SAGGESE Michael L.
- Journal article citation:
- Families in Society, 86(4), December 2005, pp.558-564.
- Publisher:
- The Alliance for Children and Families
Clinicians need easy-to-use, practical, systematic methods of evaluating, informing, and reporting the effectiveness of treatment. Practicing clinicians no longer have to rely on the DSM for treating their clients, but by making use of both outcome and process measures they can create a more collaborative and effective therapy with their clients. The findings from over 40 years of psychotherapy outcome research literature emphasize the importance of common factors as the curative elements central to all forms of therapy regardless of theoretical orientation. Methods discussed here offer practitioners the means to identify which clients are responding to treatment and those for which treatment is not working so that adjustments can be made to the therapy. The goal is to decrease dropout rates, increase levels of customer satisfaction, and document and improve the overall effectiveness of treatment.
Does additional care provided by a consumer self-help group improve psychiatric outcome? A study in an Italian community-based psychiatric service
- Authors:
- BURTI Lorenzo, et al
- Journal article citation:
- Community Mental Health Journal, 41(6), December 2005, pp.705-720.
- Publisher:
- Springer
This study compares the two-year clinical and social outcome, the use of services and the direct costs of patients of the South-Verona Community Psychiatric Service who were members of a self-help group, with those who were not. Use of services and costs in the two years before the baseline were compared with those occurring two years after the baseline. Self-help subjects decreased their use of hospital stay as to number of admissions and days in hospital, with a reduction of costs; they were more satisfied as to work/education while non self-help matches presented an increase of unmet needs. Clinical and social outcome showed no significant difference. The findings suggest that consumer participation may possibly enhance the effects of psychiatric treatment on outcome.
Preliminary outcomes from a community linkage intervention for individuals with co-occurring substance abuse and serious mental illness
- Authors:
- SMELSON David A., et al
- Journal article citation:
- Journal of Dual Diagnosis, 1(3), 2005, pp.47-59.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Few interventions assist individuals with a mental illness and a co-occurring substance abuse disorder in the transition from hospitalization to outpatient treatment. This change in care is often abrupt, resulting in fragmented treatment that jeopardizes recovery. This article reports on the preliminary outcomes from a new eightweek linkage intervention entitled “Time-Limited Case Management (TLC)” that integrates intensive outreach, Dual Recovery Therapy (DRT), and peer support to facilitate outpatient treatment engagement following discharge from Acute Psychiatry. This eight-week naturalistic feasibility study included 59 recently hospitalized subjects with a mental illness and substance abuse disorder who were offered the new service. The individuals who agreed to receive TLC (n = 26) formed the treatment group and those who refused (n = 33) made up the comparison group. The TLC service was successfully implemented into the system and improved the transition from inpatient to outpatient care. The individuals who received the TLC intervention had a higher show rate at the Day Treatment Center intake appointment, attended more days of treatment at the Day Center, had greater pharmacy refill compliance, and were less likely to be lost to follow-up at eight weeks than the comparison group. TLC represents a promising new approach to maintaining continuity in care following psychiatric hospitalization that may be easily implemented in other systems. We are currently in the process of developing an implementation manual and doing a large randomized controlled trial to determine whether the intervention improves substance abuse and psychiatric outcomes in addition to facilitating treatment engagement.(Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
Cost-effectiveness of relapse-prevention cognitive therapy for bipolar disorder: 30-month study
- Authors:
- LAM Dominique H., et al
- Journal article citation:
- British Journal of Psychiatry, 186(6), June 2005, pp.500-506.
- Publisher:
- Cambridge University Press
This article reports the advantageous clinical outcome of adding cognitive therapy to medication in the prevention of relapse of bipolar disorder. This 30-month study compares the cost-effectiveness of cognitive therapy with standard care. The authors randomly allocated 103 individuals with bipolar 1 disorder to standard treatment and cognitive therapy plus standard treatment. Service use and costs were measured at 3-month intervals and cost-effectiveness was assessed using the net-benefit approach. The group receiving cognitive therapy had significantly better clinical outcomes. The extra costs were offset by reduced service use elsewhere. The probability of cognitive therapy being cost-effective was high and robust to different therapy prices. Combination of cognitive therapy and mood stabilisers was superior to mood stabilisers alone in terms of clinical outcome and cost-effectiveness for those with frequent relapses of bipolar disorder.
Patients' characteristics and treatment outcome in a group-analytic psychotherapeutic community
- Authors:
- TZIOTZIOU Anna, et al
- Journal article citation:
- Therapeutic Communities: the International Journal of Therapeutic Communities, 26(3), Autumn 2005, pp.245-260.
- Publisher:
- Emerald
This study aimed to record the characteristics of all 816 patients treated in the Psychotherapeutic Community of the Open Psychotherapy Centre (OPC) from 1980 to 1999 and the discussion of the parameters which influence outcome. It is a retrospective study, based mainly on archives of the therapeutic sector of the OPC. The data recorded concerns the epidemiological characteristics: demographic, and the psychiatric clinical. The findings indicate some factors which are statistically correlated to the outcome, such as previous hospitalization, duration of therapy, medication, diagnosis and gender. Finally a patients profile is described, based on those characteristics which are the most common.