title: Preliminary outcome study on assertive community treatment in Japan.
abstract: OBJECTIVE
  The beneficial effects of assertive community treatment (ACT), which has been widely acclaimed as being successful in several foreign countries, must also be objectively evaluated with respect to the transition from inpatient to community-based mental health treatment in Japan. This was the first study that examined effects of the ACT program in Japan using pre/post design data of the pilot trial of the ACT program in Japan project.
  
  
  METHODS
  The study included 41 subjects hospitalized at Kohnodai Hospital, National Center of Neurology and Psychiatry between May 2003 and April 2004 for severe mental illness and who met inclusion criteria for entry regarding age, diagnosis, residence, utilization of mental health services, social adjustment, and ability to function in daily activities. All subjects provided informed consent for study participation and were followed for 1 year after hospital discharge.
  
  
  RESULTS
  Comparison of the number of days and frequency of inpatient psychiatric hospitalization and frequency of emergency psychiatric visits between the 1-year period before hospitalization and 1-year period after hospital discharge showed a significant decrease in number of days and frequency of hospitalization. Comparison at 1 year after discharge with baseline showed no change in satisfaction with overall quality of life or Brief Psychiatric Rating Scale scores, but the Global Assessment of Functioning score significantly increased, and the antipsychotic dose (chlorpromazine equivalent) significantly decreased.
  
  
  CONCLUSIONS
  Despite some limitations in methodology and conclusions, this study suggests that ACT enables persons with severe mental illness to live for longer periods in the community, without worsening of symptoms, decreased social function, or deterioration in quality of life.
authors: Division of Comprehensive Welfare, Tohoku Fukushi University, Sendai, Japan. nishio@tfu-mail.tfu.ac.jp
authors: Masaaki
authors: M
authors: Nishio
authors: Junichiro
authors: J
authors: Ito
authors: Iwao
authors: I
authors: Oshima
authors: Yuriko
authors: Y
authors: Suzuki
authors: Kentaro
authors: K
authors: Horiuchi
authors: Tamaki
authors: T
authors: Sono
authors: Hiroi
authors: H
authors: Fukaya
authors: Fumie
authors: F
authors: Hisanaga
authors: Kazumi
authors: K
authors: Tsukada
mesh_terms: D000328:Adult; D003156:Community Mental Health Services / Q000379:methods*; D003688:Deinstitutionalization / Q000379:methods*; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000628:therapy; D008875:Middle Aged; D019964:Mood Disorders / Q000628:therapy*; D012559:Schizophrenia / Q000628:therapy*; D016896:Treatment Outcome