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

With respect to imprisonment, the CM had no clear effect (n = 757;
Peto odds-ratio = 0.90; 99% CI: between 0.36 and 2.28) 205 , but it does seem
more favourable to improve medication adherence (N = 71; Peto odds-ratio
= 0.25; 99% CI: between 0.06 and 0.97) 205 .
There was no difference between CM and ST in the improvement of
the mental state (n= 126; WMD = 0.461; 99% CI between -4.9 and 5.9) 205 ,
social functioning (SMD = -0.097; 99% CI CL -0.47 -0.27; N = 197) or
quality of life (N =135; SMD = 0.096; 99% CI: between -0.35 and 0.54) 205 .
Summary of evidence
No randomised clinical trials have been found to assess the efficacy of the day centres
and/or psychosocial rehabilitation centres 206 .
No statistically significant differences were found between CMHC and ST in the reduction
of hospital admissions, or in the loss of contact in the population cared for in the
1-
CMHC 8,204 .
1- There are no differences between CMHC and ST with respect to death ratios 204 .
1-
1-
1++
1-
There seem to be no differences either between CMHC and ST with respect to the evolution
of the mental state in the population cared for in CMHC 202 .
It is not clear that the CMHC is associated with an improvement in social functioning
when compared with ST 8 . However, there does seem to be a smaller number of dissatisfied
people in the group of CMHC than the ST 204 .
The ACT in people with SMI, compared with ST, is associated with more likelihood of
remaining in contact with the services, and reducing hospital admissions 8 .
The ACT reduces the probabilities of hospital admission compared with hospital-based
rehabilitation 8 .
The ACT reduces the use of beds, it decreases the risk of becoming “homeless”, greater
1++ probability of independent living, a reduction in the risk of being unemployed and an
improvement of the mental state 8 .
1- The ACT is associated with an increase in satisfaction with the services 8 .
1-
1+
1+
1+
1-
1+
“Homeless” people who receive ACT are likely to experience clinically significant improvements
in quality of life 8 .
ICM is associated with an increase in contact with the services when compared with the
CM 8 .
There are no differences between ICM and Case Management with respect to losses of
contact with their case manager 8 .
When ICM is compared with Case Management there is no evidence to indicate that an
improvement takes place in the readmission rates, the mental state or social functioning
in people with SMI 8 .
There is no evidence to indicate that ICM, in people with SMI, compared with Case
Management improves treatment adherence 8 .
ICM functions better when participants tend to use hospital care a lot. When the use of
hospital services is high, the ICM can reduce this, but no effect is produced when the use
of hospital care is low 207 .
100 CLINICAL PRACTICE GUIDELINES IN THE SPANISH NHS