The Maine and Vermont three-decade studies of serious mental illness. I. Matched comparison of cross-sectional outcome.
BACKGROUND
This study compared long-term outcome of serious mental illness in two states using a matched design to assess psychiatric rehabilitation programmes; Vermont subjects participated in a model psychiatric rehabilitation programme, while the Maine group received more traditional care.


METHODS
Maine and Vermont subjects (n = 269) were matched by age, sex, diagnosis, and chronicity. Demographic, illness, and life history information were abstracted from hospital records by clinicians blind to outcome. DSM-III criteria were applied retrospectively. Outcome was assessed by clinicians blind to history.


RESULTS
Vermont subjects alive at follow-up (n = 180) were more productive (P < 0.0009), had fewer symptoms (P < 0.002), better community adjustment (P < 0.001) and global functioning (P < 0.001) than Maine subjects (n = 119).


CONCLUSIONS
Outcome differences may be due to Vermont's model programme and a policy of allowing an earlier opportunity for community life.
D000203:Activities of Daily Living / Q000523:psychology*; D000328:Adult; D000341:Affective Disorders, Psychotic / Q000523:psychology / Q000534:rehabilitation*; D000368:Aged; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003156:Community Mental Health Services / Q000639:trends*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008281:Maine; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011618:Psychotic Disorders / Q000523:psychology / Q000534:rehabilitation*; D012050:Rehabilitation, Vocational / Q000639:trends; D012189:Retrospective Studies; D012559:Schizophrenia / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D012917:Social Adjustment; D012931:Social Environment; D016896:Treatment Outcome; D014707:Vermont