Skip to main content Accessibility help
×
Home

Intellectual functioning and outcome of patients with severe psychotic illness randomised to intensive case management: Report from the UK700 trial

  • A. Hassiotis (a1), O. C. Ukoumunne (a2), S. Byford (a3), P. Tyrer (a4), K. Harvey (a5), J. Piachaud (a6), K. Gilvarry (a7) and J. Fraser (a8)...

Abstract

Background

Little research has been carried out on the benefits of intensive case management (ICM) for people with borderline IQ and severe mental illness.

Aims

To compare outcome and costs of care of patients with severe psychotic illness with borderline IQ to patients of normal IQ and to assess whether ICM is more beneficial for the former than for the latter.

Method

The study utilises data from the UK700 multi-centre randomised controlled trial of case management. The main outcome measure was the number of days spent in hospital for psychiatric reasons. Secondary outcomes were costs of care and clinical outcome.

Results

ICM was significantly more beneficial for borderline-IQ patients than those of normal IQ in terms of reductions in days spent in hospital, hospital admissions, total costs and needs and increased satisfaction.

Conclusions

ICM appears to be a cost-effective strategy for a subgroup of patients with severe psychosis with cognitive deficits.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Intellectual functioning and outcome of patients with severe psychotic illness randomised to intensive case management
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Intellectual functioning and outcome of patients with severe psychotic illness randomised to intensive case management
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Intellectual functioning and outcome of patients with severe psychotic illness randomised to intensive case management
      Available formats
      ×

Copyright

Corresponding author

Dr A. Hassiotis, Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, Wolfson Building, 48 Riding House Street, London W1N 8AA, UK. Tel: 020 7504 9451; fax: 020 7323 1459; e-mail: a.hassiotis@ucl.ac.uk

Footnotes

Hide All

Declaration of interest

Funded by the Department of Health Research and Development Programme.

Footnotes

References

Hide All
Andreasen, N. (1989) Scale for the assessment of negative symptoms (SANS). British Journal of Psychiatry, 155 (suppl. 7), 5358.
Åsberg, G. M., Perris, C., Schalling, D., et al (1978) Comprehensive Psychopathological Rating Scale (CPRS) – development and application of a psychiatric rating scale. Acta Psychiatrica Scandinavica Supplementum, 271, 59.
Breier, A. (1999) Cognitive deficit in schizophrenia and its neurochemical basis. British Journal of Psychiatry, 174 (suppl. 37), 1618.
Chandler, D., Meisel, J., McGowen, M., et al (1996) Client outcomes in two-model capitated integrated service agencies. Psychiatric Services, 47, 175180.
Driessen, G., DuMoulin, H., Haveman, M. J., et al (1997) Persons with intellectual disability receiving psychiatric treatment. Journal of Intellectual Disability Research, 41, 512518.
Efron, B. & Tibshirani, R. J. (1993) An Introduction to the Bootstrap. New York: Chapman and Hall.
Gustafsson, C. (1997) The prevalence of people with intellectual disability admitted to general hospital psychiatric units: level of handicap, psychiatric diagnoses and care utilisation. Journal of Intellectual Disability Research, 41, 519526.
Guy, W. (1976) ECDEU Assessment Manual for Psychopharmacology, pp. 534537. Washington, DC: US Department of Health, Education & Welfare.
Hassiotis, A., Ukoumunne, O., Tyrer, P., et al (1999) Prevalence and characteristics of patients with severe mental illness and borderline intellectual functioning. British Journal of Psychiatry, 175, 135140.
Jablensky, A., Schwartz, R. & Tomov, T. (1980) WHO collaborative study of impairments and disabilities associated with schizophrenic disorders. A preliminary communication. Objectives and methods. Acta Psychiatrica Scandinavica Supplementum, 285, 152163.
Lang, F. H., Forbes, J. F. & Murray, G. D. (1997) Service provision for people with schizophrenia: I. Clinical and economic perspective. British Journal of Psychiatry, 171, 159164.
Lowe, K., Felce, D. & Blackman, D. (1996) Challenging behaviour: the effectiveness of specialist support teams. Journal of Intellectual Disability Research, 40, 336347.
Maguire, K. B. & Piersel, W. C. (1992) Specialised treatment for behaviour problems of institutionalised persons with mental retardation. Mental Retardation, 30, 227232.
Marshall, M. & Lockwood, A. (1998) Assertive community treatment for people with severe mental disorders. Cochrane Library, issue 3. Oxford: Update Software.
Marshall, M., Gray, A., Lockwood, A., et al (2000) Case management for people with severe mental disorders. Cochrane Library, issue 3. Oxford: Update Software.
McGuffin, P., Farmer, A. & Harvey, I. (1991) A polydiagnostic application of operational criteria in studies of psychotic illnesses: development and reliability of the OPCRIT system. Archives of General Psychiatry, 48, 764770.
Montgomery, S. A. & Åsberg, M. (1979) A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382389.
Muijen, M., Marks, I., Connolly, J., et al (1992) Home based care and standard hospital care for patients with severe mental illness: a randomised controlled trial. British Medical Journal, 304, 749754.
Nelson, H. E. (1982) National Adult Reading Test (NART): Test Manual. Windsor: NFER-Nelson.
Oliver, J. P. J., Huxley, P. J., Priebe, S., et al (1991) Measuring the quality of life of severely mentally ill people using the Lancashire Quality of Life Profile. Social Psychiatry and Psychiatric Epidemiology, 32, 7683.
Phelan, M., Slade, M., Thornicroft, G., et al (1995) The Camberwell Assessment of Need: the validity and reliability of an instrument to assess the needs of people with severe mental illness. British Journal of Psychiatry, 167, 589595.
Quinlivan, R., Hough, R., Crowell, A., et al (1995) Service utilisation and costs of care for severely mentally ill clients in an intensive case management program. Psychiatric Services, 46, 365371.
Tamminga, C. A., Buchanan, R. W. & Gold, J. M. (1998) The role of negative symptoms and cognitive dysfunction in schizophrenia outcomes. International Journal of Psychopharmacology, 20, (suppl. 13), 2126.
Thornicroft, G., Wykes, T., Holloway, F., et al (1998) From efficacy to effectiveness in community mental health services. PRiSM Psychosis Study 10. British Journal of Psychiatry, 173, 423427.
Tyrer, P. & Remington, M. (1979) Controlled comparison of day hospital and out-patient treatment for neurotic disorders. Lancet, i, 10141016.
Tyrer, P., Owen, R. T. & Cicchetti, D. (1984) The brief scale for anxiety: a subdivision of the Comprehensive Psychopathological Rating Scale. Journal of Neurology Neurosurgery and Psychiatry, 47, 970975.
UK700 Group (1999a) Comparison of intensive and standard case management for patients with psychosis: Rationale of the trial. British Journal of Psychiatry, 174, 7478.
UK700 Group (1999b) A randomised controlled trial of the outcome of intensive versus standard case management for severe psychotic illness: the UK700 case management trial. Lancet, 353, 21852189.
UK700 Group (2000) Cost-effectiveness of intensive v. standard case management for severe psychotic illness: the UK700 case management trial. British Journal of Psychiatry, 176, 537543.
van Minnen, A., Hoogduin, C. A. & Broekman, T. G. (1997) Hospital v. outreach treatment of patients with mental retardation and psychiatric disorders: a controlled study. Acta Psychiatrica Scandinavica, 95, 515552.
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, 385390.

Intellectual functioning and outcome of patients with severe psychotic illness randomised to intensive case management: Report from the UK700 trial

  • A. Hassiotis (a1), O. C. Ukoumunne (a2), S. Byford (a3), P. Tyrer (a4), K. Harvey (a5), J. Piachaud (a6), K. Gilvarry (a7) and J. Fraser (a8)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Intellectual functioning and outcome of patients with severe psychotic illness randomised to intensive case management: Report from the UK700 trial

  • A. Hassiotis (a1), O. C. Ukoumunne (a2), S. Byford (a3), P. Tyrer (a4), K. Harvey (a5), J. Piachaud (a6), K. Gilvarry (a7) and J. Fraser (a8)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *