title: Intensive treatment models and coercion.
abstract: Little evidence exists concerning the optimal treatment for patients with first-episode schizophrenia-spectrum disorders and the effect on traditional outcomes. The aim was to investigate whether optimal treatment models have an effect on the level of use of coercion and on traditional outcomes. Hospital-based Rehabilitation, an intensified inpatient treatment model, Integrated Treatment, an intensified model of Assertive Community Treatment, and standard treatment were compared for patients with first-episode schizophrenia-spectrum disorders. Ninety-four patients with first-episode schizophrenia-spectrum disorders estimated to benefit from long-term hospitalization were included consecutively from the Copenhagen OPUS-trial and randomized to the three treatment models. At 1-year follow-up, Hospital-based Rehabilitation and Integrated Treatment had better scores on symptoms in the negative dimension and on client satisfaction. Integrated Treatment had fewer bed-days, more patients living in non-supervised accommodation, and better score on quality of life. No differences were found as to the use of coercion. This study adds to the evidence that intensified treatment models are superior to standard treatment. A higher number of bed-days in Hospital-based Rehabilitation did not influence the effect on the outcomes measured.
authors.affiliation: Sct. Hans Hospital, Roskilde, Denmark. oeh@dadlnet.dk
authors.forename: Johan
authors.initials: J
authors.lastname: Ohlenschlaeger
authors.forename: Anne
authors.initials: A
authors.lastname: Thorup
authors.forename: Lone
authors.initials: L
authors.lastname: Petersen
authors.forename: Pia
authors.initials: P
authors.lastname: Jeppesen
authors.forename: Anne
authors.initials: A
authors.lastname: Køster
authors.forename: Runa
authors.initials: R
authors.lastname: Munkner
authors.forename: Merete
authors.initials: M
authors.lastname: Nordentoft
mesh_terms: D000328:Adult; D002985:Clinical Protocols; D003068:Coercion; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data; D003156:Community Mental Health Services / Q000379:methods*; D003718:Denmark; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008134:Long-Term Care; D008297:Male; D010352:Patient Dropouts; D017060:Patient Satisfaction; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011613:Psychotherapy / Q000379:methods; D011618:Psychotic Disorders / Q000175:diagnosis / Q000534:rehabilitation / Q000628:therapy*; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012559:Schizophrenia / Q000175:diagnosis / Q000534:rehabilitation / Q000628:therapy*; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D011619:Psychotropic Drugs