Identifying an optimal treatment for schizophrenia: A 2-year randomized controlled trial comparing integrated care to a high-quality routine treatment

Sungur, Mehmet Z.; Soygür, Haldun; Güner, Perihan; Üstün, Besti; Cetin, Ilkten; Falloon, Ian R. H.

doi:10.3109/13651501.2011.554987

Cited by 26 publications

(46 citation statements)

References 30 publications

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“…A better client satisfaction with care [33,40], feeling safe [42], and a significant reduction in caregiver stress [38] were reported in several studies.…”

Section: Patient and Carer Satisfactionmentioning

confidence: 81%

“…Sungur et al [38] compared Optimal Case Management (OCM) with a high-quality Routine Case Management (RCM) in a group of 100 patients with schizophrenia and their caregivers in Turkey as part of the multisite international 'Optimal Treatment Project' (OTP). OCM referred to delivering evidence-based treatment strategies [e.g., cognitive behaviour therapy (CBT), CBT family interventions, psychoeducation] and using elements of ACT.…”

Section: Key Pointsmentioning

confidence: 99%

“…Just a few studies measured QoL as outcome parameter and in all studies improvements could be shown[38,49 Hospital utilization, use of care, and adherence Hospital use depends on the mental health care system in which the intervention takes place. Just a few studies measured QoL as outcome parameter and in all studies improvements could be shown[38,49 Hospital utilization, use of care, and adherence Hospital use depends on the mental health care system in which the intervention takes place.…”

mentioning

confidence: 99%

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Integrated care in patients with schizophrenia

Schöttle

Karow

Schimmelmann

et al. 2013

Current Opinion in Psychiatry

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“…A better client satisfaction with care [33,40], feeling safe [42], and a significant reduction in caregiver stress [38] were reported in several studies.…”

Section: Patient and Carer Satisfactionmentioning

confidence: 81%

Section: Key Pointsmentioning

confidence: 99%

mentioning

confidence: 99%

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Integrated care in patients with schizophrenia

Schöttle

Karow

Schimmelmann

et al. 2013

Current Opinion in Psychiatry

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“…The diagnoses of 86 % (1955) of the clients were within the psychotic spectrum, while 14 % (308) were found to display the whole range of typical psychiatric diagnoses such as delusional syndrome, addiction syndrome, depression, panic disorder, anxiety disorders, obsessive-compulsive disorder, behavioral disorders, personality disorders, and attentional disorders. Six randomized controlled trials of Resource Group Assertive Community Treatment (RACT) were compared with standard care treatment [18, 20, 22, 23, 26, 27]. In addition, there were eleven observational studies where eight compared pre- and post-RACT treatment outcomes [11, 15-17, 19, 24, 25, 28] and three compared interventions with RACT and the standard care treatment [10, 14, 21].…”

Section: Materials and Methodologymentioning

confidence: 99%

Resource Group Assertive Community Treatment (RACT) as a Tool of Empowerment for Clients with Severe Mental Illness: A Meta-Analysis

Nordén¹,

Malm²,

Norlander³

2012

CPEMH

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The aim of the current meta-analysis was to explore the effectiveness of the method here labeled Resource Group Assertive Community Treatment (RACT) for clients with psychiatric diagnoses as compared to standard care during the period 2001 – 2011. Included in the meta-analysis were 17 studies comprising a total of 2263 clients, 1291 men and 972 women, with a weighted mean age of 45.44 years. The diagnoses of 86 % of the clients were within the psychotic spectrum while 14 % had other psychiatric diagnoses. There were six randomized controlled trials and eleven observational studies. The studies spanned between 12 and 60 months, and 10 of them lasted 24 months. The results indicated a large effect-size for the ”grand total measure” (Cohen´s d = 0.80). The study comprised three outcome variables: Symptoms, Functioning, and Well-being. With regard to Symptoms, a medium effect for both randomized controlled trials and non-randomized studies was found, whereas Functioning showed large effects for both types of design. Concerning Well-being both large and medium effects were evident. The conclusions of the meta-analysis were that the treatment of clients with Resource Group Assertive Community Treatment yields positive effects for clients with psychoses and that the method may be of use for clients within the entire psychiatric spectrum.

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“…Guiding outpatients with schizophrenia in choosing optimal antipsychotic therapy for participating in psychosocial rehabilitation is complex and poorly understood (Salkever et al, 2006; Sungur et al, 2011). Antipsychotic medications may be associated with side effects such as sedation and EPS that can interfere with attention, learning and motor function (Kumar et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Risperidone versus olanzapine among patients with schizophrenia participating in supported employment: Eighteen-month outcomes

Noordsy

Glynn²,

Sugar³

et al. 2017

Journal of Psychiatric Research

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This study compares the efficacy and tolerability of olanzapine versus risperidone among patients with schizophrenia who are established in outpatient psychiatric care and entering supported employment. A multicenter, randomized, double-blind trial was conducted among 107 outpatients with schizophrenia, who were cross-titrated to flexible dose risperidone or olanzapine over 2 weeks. Clinical endpoints included time to hospitalization and persistence on assigned medication. Weight, laboratory tests, psychopathology, neurologic side effects, social adjustment and role functioning were assessed at 3–6 month intervals. Data were analyzed first by randomized treatment, and then reassessed controlling for prior medication treatment. The proportion of patients on assigned medication at 18 months was 30.9% for risperidone and 37.3% for olanzapine. Mean doses were 6.4+/−3.2 mg daily for risperidone, and 17.0+/−5.0mg daily for olanzapine. The groups did not differ significantly in time to medication discontinuation, first hospitalization or first employment. There were few differences in psychopathology, laboratory, or neurological assessments between groups at 18 months. Patients randomized to olanzapine gained modestly more weight. Controlling for pre-randomization medication suggested improvement in some aspects of psychopathology from switching medications; however, switching from olanzapine to risperidone was associated with more hospitalizations. Risperidone and olanzapine have similar efficacy and tolerability in patients with schizophrenia who are participating in supported employment. Randomization to olanzapine was associated with more weight gain, but randomization from olanzapine to risperidone appeared to be associated with a greater likelihood of hospitalization. Careful monitoring of metabolic effects and participation in supported employment may have contributed to minimal weight gain and metabolic effects.

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Identifying an optimal treatment for schizophrenia: A 2-year randomized controlled trial comparing integrated care to a high-quality routine treatment

Abstract: This study helps demonstrate the importance of psychosocial interventions in the treatment of schizophrenia. Recent advances in evidence-based psychosocial strategies can be implemented into routine clinical practice with additional clinical and social benefits.

Cited by 26 publications

References 30 publications

Integrated care in patients with schizophrenia

Integrated care in patients with schizophrenia

Resource Group Assertive Community Treatment (RACT) as a Tool of Empowerment for Clients with Severe Mental Illness: A Meta-Analysis

Risperidone versus olanzapine among patients with schizophrenia participating in supported employment: Eighteen-month outcomes

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