title: [Cognitive Behavioral Therapy and Assertive Community Treatment Reduces Days in Hospital and Delays Hospital Admission in Severe Psychotic Disorders].
abstract: The primary aim of this study was to assess the effectiveness of integrated home treatment (IV, i. e. intensive cognitive behavioral therapy and pharmacotherapy provided within a framework of assertive community treatment) in individuals with severe mental disorders (n = 13) within the German healthcare system. A treatment-as-usual group (TAU, n = 13) was identified by propensity score matching. Symptoms (CGI), functioning (GAF) and service engagement (SES) were assessed. Quality of life (MSLQ-R) was rated by the IV patients. A reduction of days spent in hospital [IV: 2.3 (6.1); TAU: 33.6 (53.6); Z = 45; p = 0.044], time to admission (IV: 384 days 95% CI 309 - 459.1; TAU: 234.9 days 95% CI 127.2 - 342.5; log rank: Chi-square = 4.31, p < 0.05), severity of the illness (p < 0.01), positive symptoms (p < 0.001), and cognitive symptoms (p < 0.05), as well as functioning (p < 0.05) and service engagement (p < 0.05) was observed in IV patients. Despite differences on a descriptive level, differences in total admissions (IV: 15.3%; TAU: 53.8%; odds ratio = 0.155, 95% CI 0.0243 - 1.00) were not significant. A methodological limitation is that symptom ratings were not performed by independent and blinded raters.
authors.affiliation: Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinik Köln.
authors.forename: H
authors.initials: H
authors.lastname: Müller
authors.affiliation: Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinik Köln.
authors.forename: I
authors.initials: I
authors.lastname: Haag
authors.affiliation: Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinik Köln.
authors.forename: F
authors.initials: F
authors.lastname: Jessen
authors.affiliation: Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinik Köln.
authors.forename: E H
authors.initials: EH
authors.lastname: Kim
authors.affiliation: Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinik Köln.
authors.forename: J
authors.initials: J
authors.lastname: Klaus
authors.affiliation: Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinik Köln.
authors.forename: C
authors.initials: C
authors.lastname: Konkol
authors.affiliation: Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinik Köln.
authors.forename: A
authors.initials: A
authors.lastname: Bechdolf
mesh_terms: D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003153:Community Health Services; D023381:Endpoint Determination; D005260:Female; D005858:Germany; D006699:Home Care Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life