CPG for Psychosocial Interventions in Severe Mental ... - GuíaSalud

There is not sufficient evidence, either, in terms of pharmacological
treatment adherence (n = 68; RR = 1.32, 95% CI: between 0.46 and 3.75) 8 .
With respect to mental state no differences have been found between
ICM and standard CM with respect to mental state (BPRS/CPRS endpoint
score n = 823; WMD = 0.02; 95% CI: between -0.12 and 0.16) 8 or to social
functioning (Disability Assessment Schedule/Life Skills Profi le = 641; WMD
= -0.08; 95% CI: between -0.24 and 0.07) 8 .
ICM functions better when participants tend to use hospital care a lot.
When the use of a hospital services is high, the ICM can reduce it (p=0.001),
but no effect is produced when the use of hospital care is low 207 .
Respect to ICM teams that are organised in agreement with the ACT
model, they were more likely to reduce the use of hospital care (p=0.029),
but this finding was not encountered when the personnel levels recommended
for ACT were analysed 207 .
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5.3.5. Non-acute Day Hospitals
There are no differences between non-acute day hospitals and outpatients
treatment for people with SMI with respect to the number of follow-up losses
(at 18 months: n = 80; RR = 1.75; 95% CI: between 0.56 and 5.51)8 admission
rates (at 12 months: n = 162; RR = 0.86; 95% CI: between 0.61 and
1.23; at 24 months n = 162; RR = 0.82; 95% CI: between 0.64 and 1.05)8,
and mental state (Symptom Check List–90: n = 30; WMD = 0.31; 95% CI:
between -0.20 and 0.82) 8 .
There is not sufficient evidence, either, to be able to determine if there
is any difference between non-acute day hospitals and outpatients treatment
for people with SMI with respect to social functioning (Community
Adaptation Scale: n = 30; WMD = -0.03; 95% CI: between -0.30 and 0.24) 8 .
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5.3.6. Case Management (CM)
Case Management vs. Standard treatment (ST)
People included in Case Management are more likely to remain in contact
with the services, compared with those who receive ST (n = 1210, Peto
odds-ratio = 0.70; 99% CI: between 0.50 and 0.98) 205 .
There are no differences with respect to mortality in patients between
either intervention (n = 1341; Peto odds-ratio = 1.29; 99% CI between 0.55
and 3.00) 205 .
People who were in the CM group were approximately twice as likely
to be admitted into a psychiatric hospital (n = 1300; Peto odds-ratio = 1.84;
99% CI: between 1.33 and 2,57) as patients who received ST 205 .
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CLINICAL PRACTICE GUIDELINES FOR PSICHOSOCIAL INTERVENTIONS IN SEVERE MENTAL ILLNESS 99