title: Efficacy of aftercare services for people with severe mental disorders in Iran: a randomized controlled trial.
abstract: OBJECTIVE
  This study aimed to determine whether aftercare services reduced the number of rehospitalizations and length of hospital stay among patients with severe mental disorders.
  
  
  METHODS
  A total of 120 patients with schizophrenia and schizoaffective or bipolar disorder between the ages of 15 and 65 were recruited from 2010 to 2012 for a randomized controlled trial. The participants were followed up for 20 months after discharge from a university-affiliated hospital in Tehran, Iran. The selection procedure was random sampling. Sixty patients received aftercare services, which included treatment follow-up, family psychoeducation, and patient social skills training, and 60 patients received treatment as usual. Number of hospitalizations and length of hospital stay were primary outcome measures, and severity of psychopathology and severity of illness were secondary outcome measures. The quantitative primary and secondary outcomes measures were compared by using repeated-measures analysis.
  
  
  RESULTS
  Three members of the control group did not complete the study. The cumulative number of hospitalizations during the follow-up period was 55 for the control group and 26 for the intervention group. Length of stay was significantly greater in the control group compared with the intervention group (rate ratio=2.38, 95% confidence interval=2.17-2.62). Psychopathology was less severe in the intervention group compared with the control group (p<.001).
  
  
  CONCLUSIONS
  Aftercare services are efficacious for reducing both the need for rehospitalization and the severity of psychopathology.
authors.affiliation: All of the authors are with the Iran University of Medical Sciences, Tehran, Islamic Republic of Iran, where Dr. Ghadiri Vasfi and Dr. Hajebi are with the Mental Health Research Center and the Faculty of Behavioral Sciences and Mental Health, Dr. Moradi-Lakeh is with the Department of Community Medicine, and Ms. Esmaeili and Mr. Soleimani are with the Department of Psychology in Mental Hospital. Dr. Moradi-Lakeh is also with the Institute for Health Metrics and Evaluation, Seattle, Washington. Send correspondence to Dr. Hajebi (e-mail: hajebi.a@iums.ac.ir ).
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ghadiri Vasfi
authors.forename: Maziar
authors.initials: M
authors.lastname: Moradi-Lakeh
authors.forename: Nazanin
authors.initials: N
authors.lastname: Esmaeili
authors.forename: Naser
authors.initials: N
authors.lastname: Soleimani
authors.forename: Ahmad
authors.initials: A
authors.lastname: Hajebi
mesh_terms: D000293:Adolescent; D000328:Adult; D000359:Aftercare / Q000379:methods* / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D001714:Bipolar Disorder / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007492:Iran; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011618:Psychotic Disorders / Q000628:therapy*; D011788:Quality of Life / Q000523:psychology; D012559:Schizophrenia / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult