Treatment outcome in patients receiving assertive community treatment

Community Ment Health J. 2010 Aug;46(4):330-6. doi: 10.1007/s10597-009-9257-9. Epub 2009 Oct 22.

Abstract

In an observational study of severely mentally ill patients treated in assertive community treatment (ACT) teams, we investigated how treatment outcome was associated with demographic factors, clinical factors, and motivation for treatment. To determine psychosocial outcome, patients were routinely assessed using the Health of the Nation Outcome Scales (HoNOS). Trends over time were analyzed using a mixed model with repeated measures. The HoNOS total score was modeled as a function of treatment duration and patient-dependent covariates. Data comprised 637 assessments of 139 patients; mean duration of follow-up was 27.4 months (SD = 5.4). Substance abuse, higher age, problems with motivation, and lower educational level were associated with higher HoNOS total scores (i.e., worse outcome). To improve treatment outcome, we recommend better implementation of ACT, and also the implementation of additional programs targeting subgroups which seem to benefit less from ACT.

MeSH terms

  • Adult
  • Age Factors
  • Alcoholism / diagnosis
  • Alcoholism / psychology
  • Alcoholism / rehabilitation*
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / psychology
  • Bipolar Disorder / rehabilitation*
  • Community Mental Health Services*
  • Educational Status
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motivation
  • Netherlands
  • Outcome and Process Assessment, Health Care*
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / psychology
  • Psychotic Disorders / rehabilitation*
  • Schizophrenia / diagnosis
  • Schizophrenia / rehabilitation*
  • Schizophrenic Psychology*
  • Sex Factors
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / rehabilitation*