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Quality of life outcomes for intensive versus standard community mental health services

PRiSM Psychosis Study 9

Published online by Cambridge University Press:  02 January 2018

Ruth E. Taylor ,
Morven Leese ,
Clarkson Paul ,
Frank Holloway  and
Graham Thornicroft
Ruth E. Taylor*
Affiliation:
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Morven Leese
Affiliation:
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Clarkson Paul
Affiliation:
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Frank Holloway
Affiliation:
Maudsley Hospital, London
Graham Thornicroft
Affiliation:
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
*
Ruth E. Taylor, Department of Psychiatry, Institute of Psychiatry, De Crespigny Park, Camberwell. London SE5 8AF.
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Abstract

Background

We report the impact on the quality of life (QOL) of people with psychosis of an intensive compared with a standard model of community care.

Method

People with psychosis, in two sectors in south London, were interviewed with a variety of measures at baseline, and at two-year follow-up (n=138). After baseline, services within one sector were reorganised, and a more intensive model of community care was introduced. QOL was measured using the Lancashire Quality of Life Profile.

Results

The two overall QOL measures, global QOL and the average of the domain-specific scores, were remarkably stable over time. There was weak evidence for an improvement in living situation domain in the intensive sector; this may be accounted for by a large drop in in-patient admissions. In both sectors objective QOL was poor, and there was little change in any of the objective indicators except in-patient admissions, and a suggestion of increased social activity in the intensive sector.

Conclusions

We failed to find an effect of intensive community care on QOL in people with psychosis. This may indicate an insensitivity to change in QOL measures, or that the intervention failed to produce the kind of changes in mental health and functioning which would be reflected in improved QOL.

Type
PRiSM Psychosis Study
Information
The British Journal of Psychiatry , Volume 173 , Issue 5 , November 1998 , pp. 416 - 422
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-III-R). Washington, DC: APA.Google Scholar
Baker, F. & Intagliata, J. (1982) Quality of life in the evaluation of community support systems. Evaluation and Program Planning, 5, 69–79.Google Scholar
Barry, M. M. & Crosby, C. (1996) Quality of life as an evaluative measure in assessing the impact of community care on people with long-term psychiatric disorders. British Journal of Psychiatry, 168, 210–216.CrossRefGoogle ScholarPubMed
Barry, M. M. & Zissi, A. (1997) Quality of life as an outcome measure in evaluating mental health services: a review of the empirical evidence. Social Psychiatry and Psychiatric Epidemiology, 32, 38–47.Google Scholar
Beecham, J. & Knapp, M. (1992) Costing psychiatric interventions. In Measuring Mental Health Needs, (eds Thornicroft, G., Brewin, C. R. & Wing, J. K.) pp. 163–183. London: Gaskell.Google Scholar
Becker, T., Thornicroft, G., Leese, M., et al (1997) Social networks and service use among representative cases of psychosis in south London. British Journal of Psychiatry, 171, 15–19.Google Scholar
Becker, T., Holloway, F., McCrone, P., et al (1998a) Evolving service interventions in Nunhead and Norwood. PRiSM Psychosis Study 2. British Journal of Psychiatry, 173, 371–375.Google Scholar
Becker, T., Leese, M., McCrone, P., et al (1998b) Impact of community mental health services on users' social networks. PRiSM Psychosis Study 7. British Journal of Psychiatry, 173, 404–408.CrossRefGoogle ScholarPubMed
Davies, S., Thornicroft, G., Leese, M., et al (1996) Ethnic differences in the risk of compulsory psychiatric admissions among representative cases of psychosis in London. British Medical Journal, 312, 533–537.CrossRefGoogle Scholar
Dunn, M., O'Driscoll, C., Dayson, D., et al (1990) The TAPS project 4: An observational study of the social life of long-stay patients. British Journal of Psychiatry, 157, 842–848.Google Scholar
Fletcher, A. (1995) Quality-of-life measurements in the evaluation of treatment: proposed guidelines. British Journal of Clinical Pharmacology, 39, 217–222.Google Scholar
Gibbons, J. S. & Butler, J. P. (1987) Quality of life for ‘new’ long-stay psychiatric in-patients: the effects of moving to a hostel. British Journal of Psychiatry, 151, 347–354.Google Scholar
Leese, M., Johnson, S., Slade, M., et al (1998) User perspective on needs and satisfaction with mental health services. PRiSM Psychosis Study 8. British Journal of Psychiatry, 173, 409–415.Google Scholar
Lehman, A. F. (1983) The effects of psychiatric symptoms on quality of life assessments among the chronically mentally ill. Evaluation and Program Planning, 6, 143–151.CrossRefGoogle Scholar
Lehman, A. F. (1988) A quality of life interview for the chronically mentally ill. Evaluation and Program Planning, 11, 51–62.CrossRefGoogle Scholar
Lehman, A. F. Ward, N. C. & Linn, L. C. (1982) Chronic mental patient: the quality of life issue. American Journal of Psychiatry, 139, 1271–1275.Google Scholar
McGuffin, P., Farmer, A. E. & Harvey, I. H. (1991) A polydiagnostic application of operational criteria in studies of psychotic illness: development and reliability of the OPCRIT system. Archives of General Psychiatry, 48, 764–770.Google Scholar
Okin, R. L., Dolnick, J. A. & Pearsall, D. (1983) Patients' perspectives on community alternatives to hospitalisation: a follow up study. American Journal of Psychiatry, 140, 1460–1464.Google Scholar
Olfson, M. (1990) Assertive community treatment: an evaluation of the experimental evidence. Hospital and Community Psychiatry, 41, 634–641.Google Scholar
Oliver, J. P. J. (1991) The Social Care Directive: development of a Quality of Life Profile for use in community services for the mentally ill. Social Work and Social Sciences Review, 3, 5–45.Google Scholar
Oliver, J. P. J. Huxley, P. J., Priebe, S., et al (1997) Measuring the quality of life of severely mentally ill people using the Lancashire Quality of Life Profile. Social Psychiatry and Psychiatric Epidemiology, 32, 76–83.CrossRefGoogle ScholarPubMed
Pinkney, A. A., Gerber, G. J. & Lafave, H. G. (1991) Quality of life after psychiatry rehabilitation: the clients' perspectives. Acta Psychiatrica Scandinavica, 83, 89–91.Google Scholar
Simes, R. J. (1986) An improved Bonferroni procedure with multiple tests of significance. Biometrika, 73, 751–754.Google Scholar
Simpson, C. J., Hyde, C. E. & Faragher, E. B. (1989) The chronically mentally ill in community facilities: a study of quality of life. British Journal of Psychiatry, 154, 77–82.Google Scholar
Stein, L. I. & Test, M. A. (1980) Alternatives to mental hospital treatment. Archives of General Psychiatry, 37, 392–397.Google Scholar
Sullivan, G., Wells, K. B. & Leake, B. (1991) Quality of life of seriously mentally ill persons in Mississippi. Hospital and Community Psychiatry, 42, 752–754.Google Scholar
Ventura, J., Green, M. F., Shaner, A., et al (1993a) Training and Quality Assurance with the Brief Psychiatric Rating Scale: ‘The Drift Busters’. International Journal of Methods in Psychiatric Research, 3, 221–244.Google Scholar
Ventura, J., Lukoff, D., Nuechterlein, K. H., et al (1993b) Brief Psychiatric Rating Scale (BPRS) Expanded Version (4.0) Scales, Anchor Points and Administration Manual. International Journal of Methods in Psychiatric Research, 3, 227–243.Google Scholar
World Health Organization (1992) SCAN. Schedules for Clinical Assessment in Neuropsychiatry. Geneva: World Health Organization, Division of Mental Health.Google Scholar
Wykes, T. & Sturt, E. (1986) The measurement of social behaviour in psychiatric patients: An assessment of the reliability and validity of the SBS schedule. British Journal of Psychiatry, 148, 1–11.Google Scholar
Wykes, T. Leese, M., Taylor, R., et al (1998) Effects of community services on disability and symptoms. PRiSM Psychosis Study 4. British Journal of Psychiatry, 173, 385–390.CrossRefGoogle ScholarPubMed
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