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Rationale and design

PRiSM Psychosis Study 1

Published online by Cambridge University Press:  02 January 2018

Graham Thornicroft
Affiliation:
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Geraldine Strathdee
Affiliation:
Oxleas NHS Trust, Laurel House, 2 Blean Grove, Penge
Michael Phelan
Affiliation:
Charing Cross Hospital, Fulham Palace Road, London
Frank Holloway
Affiliation:
Maudsley Hospital, Denmark Hill, London
Til Wykes
Affiliation:
Department of Psychology, Institute of Psychiatry, London
Graham Dunn
Affiliation:
University of Manchester, Oxford Road, Manchester
Paul McCrone
Affiliation:
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Morven Leese
Affiliation:
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Sonia Johnson
Affiliation:
Department of Psychiatry & Behavioural Sciences, University College London Medical School, 48 Riding House Street, London
George Szmukler
Affiliation:
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, De Crespigny Park, London

Abstract

Background

This paper sets out the rationale for the PRiSM Psychosis Study, and the research design used. Nine accompanying papers present the main results. The questions addressed by the PRiSM Psychosis Study are: can the gains of experimental studies which have demonstrated benefits arising from treatment by community mental health teams be translated to routine settings? If so, are the benefits diluted in ordinary clinical practice? What are the costs?

Method

A prospective non-randomised controlled trial of two types of community mental health service, in two phases: case identification followed by patient interviews. For the case identification the research team conducted the complete ascertainment of all prevalent cases of psychosis in the two study catchment areas in the index year (1991–1992). From all 514 patients with psychotic disorders thus identified, 302 were randomly allocated for interview, along with a key informant clinician and a carer. Interviews were undertaken at two time points, two years apart.

Results

This paper presents the socio-demographic, clinical and ethnic characteristics of the patients.

Conclusions

The people with psychosis interviewed for the PRiSM Psychosis Study are representative of the whole epidemiologically based patient population identified.

Type
PRiSM Psychosis Study
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest

Funding provided by the Bethlem & Maudsley NHS Trust.

References

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, 371375.CrossRefGoogle ScholarPubMed
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, 404408.CrossRefGoogle ScholarPubMed
Bennett, D. & Watts, F. (1991) Community Psychiatry. London: Churchill Livingstone.Google ScholarPubMed
Blazer, D., George, L. K., Landerman, R., et al (1985) Psychiatric disorders: a rural/urban comparison. Archives of General Psychiatry, 42, 651656.CrossRefGoogle ScholarPubMed
Borga, P., Widerlov, B., Stefansson, C. G., et al (1992) Social conditions in a total population with long-term functional psychosis in three different areas of Stockholm County. Acta Psychiatrica Scandinavica, 85, 465473.CrossRefGoogle Scholar
Burns, T., Beardsmore, A., Bhat, A. V., et al (1993) A controlled trial of home-based acute psychiatric services. I: Clinical and social outcome. British Journal of Psychiatry, 163, 4954.CrossRefGoogle ScholarPubMed
Davies, S., Thomicroft, G., Leese, M., et al (1996) Ethnic differences in risk of compulsory admission among representative cases of psychosis in London. British Medical Journal, 312, 533537.CrossRefGoogle Scholar
Department of Health (1994a) The Health of the Nation, 2nd edn. London: HMSO.Google ScholarPubMed
Department of Health (1994b) Mental Illness Key Area Handbook, 2nd edn. London: HMSO.Google Scholar
Endicott, J., Spitzer, R. L., Fleiss, J. L., et al (1976) The Global Assessment Scale. A procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry, 33, 766771.CrossRefGoogle ScholarPubMed
Faris, R. & Dunham, H. (1939) Mental Disorders in Urban Areas. Chicago, IL: University of Chicago Press.Google Scholar
Fenton, F., Tessier, L., Struening, E., et al (1982) Home and Hospital Psychiatric Treatment. London: Croom Helm.Google ScholarPubMed
Franklin, J., Solovitz, B., Mason, M., et al (1987) An evaluation of case management. American Journal of Public Health, 77, 674678.CrossRefGoogle ScholarPubMed
Glover, G. (1996) The Mental Illness Needs Index (MINI). In Commissioning Mental Health Services (eds Thornicroft, G. & Strathdee, G.), pp. 5357. London: HMSO.Google Scholar
Goldberg, D. & Williams, P. (1988) A Users Guide to the General Health Questionnaire. Windsor: NFER-Nelson.Google Scholar
Goldman, H. (1981) Defining and counting the chronically mentally ill. Hospital and Community Psychiatry, 32, 2127.Google ScholarPubMed
Goldman, H. Morrissey, J. & Ridgely, S. (1994) Evaluating the Robert Wood Johnson Foundation Program on Chronic Mental Illness. Millbank Quarterly, 72, 3748.CrossRefGoogle Scholar
Harrison, G., Owens, D., Holton, A., et al (1988) A prospective study of severe mental disorder in Afro-Caribbean patients. Psychological Medicine, 16, 643657.CrossRefGoogle Scholar
Harvey, C. A., Pantelis, C., Taylor, J., et al (1996) The Camden schizophrenia serveys. II. High prevalence of schizophrenia in an inner London borough and its relationship to socio-demographic factors. British Journal of Psychiatry, 168, 418426.CrossRefGoogle Scholar
Hoult, J. (1986) Community care of the acutely mentally ill. British Journal of Psychiatry, 149, 137144.CrossRefGoogle ScholarPubMed
House of Commons Health Select Committee (1994) Better Off in the Community? The Care of People who are Seriously Mentally III. London: HMSO.Google Scholar
Jarman, B. (1984) Underprivileged areas: validation and distribution of scores. British Medical Journal, 289, 15871592.CrossRefGoogle ScholarPubMed
Johnson, S., Ramsay, R., Thornicroft, G., et al (1997) London's Mental Health. London: King's Fund.Google Scholar
Johnson, S., Ramsay, R., Thornicroft, G., Leese, M., Brooks, L., et al (1998) Frequency and predictors of adverse events. PRiSM Psychosis Study 3. British Journal of Psychiatry, 173, 376384.CrossRefGoogle ScholarPubMed
King, M., Coker, E., Leavey, G., et al (1994) Incidence of psychotic illness in London: comparison of ethnic groups. British Medical Journal, 309, 11151119.CrossRefGoogle ScholarPubMed
Knapp, M. R. J. (1995) The Economic Evaluation of Mental Health Care. Aldershot: Arena.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, 409415.CrossRefGoogle ScholarPubMed
Leff, J., O'Driscoll, C., Dayson, D., et al (1990) The TAPS Project. 5: The structure of social-network data obtained from long-stay patients. British Journal of Psychiatry, 157, 848852.CrossRefGoogle ScholarPubMed
Leighton, D. C., Harding, J. S., Macklin, D. B., et al (1963) The Character of Danger (Stirling County Study Vol. 3). New York: Basic Books.Google Scholar
Lewis, G., David, A., Andreasson, S., et al (1992) Schizophrenia and city life. Lancet, 340, 137140.CrossRefGoogle ScholarPubMed
McCrone, P., Thornicroft, G., Phelan, M., et al (1998) Utilisation and costs of community mental health services. PRiSM Psychosis Study 5. British Journal of Psychiatry, 173, 391398.CrossRefGoogle ScholarPubMed
McGuffin, P., Farmer, A. & Harvey, I. (1991) A polydiagnostic application of operational criteria in studies in psychotic illness: development of reliability of the OPCRIT system. Archives of General Psychiatry, 48, 764770.CrossRefGoogle ScholarPubMed
Meitzer, H., Gill, B., Petticrew, M., et al (1995) The Prevalence of Psychiatric Morbidity among Adults living in Private Households. London: HMSO.Google Scholar
Merson, S., Tyrer, P., Onyett, S., et al (1992) Early intervention in psychiatric emergencies: a controlled clinical trial. Lancet, 339, 13111314.CrossRefGoogle ScholarPubMed
Morrissey, J. P. & Goldman, H. H. (1984) Cycles of reform in the care of the chronically mentally ill. Hospital and Psychiatry, 35, 785793.Google ScholarPubMed
Muijen, M., Marks, I., Connolly, J., et al (1992) Home based care and standard hospital care for patient with severe mental illness: a randomised controlled trial. British Medical Journal, 304, 749754.CrossRefGoogle ScholarPubMed
Office of Population Censuses and Surveys (1991) The 1991 Census. Small Area Statistics. London: HMSO.Google Scholar
Oliver, J. (1991) The Social Care Directive: development of a quality of life profile for use in community services for the mentally ill. Social Work & Social Sciences Review, 3, 545.Google Scholar
Overall, J. & Gorham, D. (1962) Brief Psychiatric Rating Scale. Psychological Reports, 10, 799812.CrossRefGoogle Scholar
Phelan, M., Slade, M., Thornicroft, G., et al (1995) The Camber well Assessment of Need (CAN): the validity and reliability of an instrument to assess the needs of people with severe mental illness. British Journal of Psychiatry, 167, 589595.CrossRefGoogle Scholar
Plewis, I. (1991) Analysing data from longitudinal comparative studies. In New Developments in Statistics for Psychology and the Social Sciences (ed. Lovie, A. D.), pp. 3872. London: British Psychological Society and Routledge.Google Scholar
Regier, D. A., Boyd, J. H., Burke, J. D., et al (1988) One month prevalence of mental disorders in the United States. Archives of General Psychiatry, 45, 977986.CrossRefGoogle ScholarPubMed
Robins, L. N., Locke, B. Z. & Regier, D. A. (1991) An overview of psychiatric disorders in America. In Psychiatric Disorders in America (eds Robins, L. & Reuter, D.), pp. 328364. New York: Free Press.Google Scholar
Ruggeri, M. & Dall'Agnola, R. (1993) The development and use of Verona Expectations for Care Scale (VECS) and the Verona Service Satisfaction (VSSS). Psychological Medicine, 23, 511524.CrossRefGoogle Scholar
Sartorius, N., Jablensky, A., Korten, A., et al (1986) Early manifestations and first-contact incidence of schizophrenia in different cultures. Psychological Medicine, 16, 909928.CrossRefGoogle ScholarPubMed
Schinnar, A. P., Rothbard, A. B., Kanter, R., et al (1990) An empirical literature review of definitions of severe and persistent mental illness. American Journal of Psychiatry, 147, 16021608.Google ScholarPubMed
Slade, M., Powell, R. & Strathdee, G. (1997) Current approaches to identifying the severely mentally ill. Social Psychiatry and Psychiatric Epidemiology, 32, 177184.CrossRefGoogle ScholarPubMed
Srole, L., Langner, T., Michael, S. T., et al (1962) Mental Health in the Metropolis. New York: McGraw-Hill.Google ScholarPubMed
StataCorp (1992) Stata Statistical Software. College Station, TX: Stata Corporation.Google ScholarPubMed
Stein, L. I. & Test, M. A. (1980) Alternative to mental hospital treatment. Archives of General Psychiatry, 37, 392397.CrossRefGoogle ScholarPubMed
Szmukler, G. (1998) The experience of care-giving inventory. Psychological Medicine, in press.Google Scholar
Szmukler, G. Wykes, T. & Parkman, S. (1998) Care-giving and the impact on carers of a community mental health services. PRiSM Psychosis Study 6. British Journal of Psychiatry, 173, 399403.CrossRefGoogle ScholarPubMed
Taylor, R. E., Leese, M., Clarkson, P., et al (1998) Quality of life outcomes for intensive versus standard community mental health services. PRiSM Psychosis Study 9. British Journal of Psychiatry, 173, 416422.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
Torrey, E. F. (1987) Prevalence studies in schizophrenia. British Journal of Psychiatry, 150, 598608.CrossRefGoogle Scholar
Tyrer, P., Morgan, J., Van Horn, E., et al (1995) A randomised controlled study of close monitoring of vulnerable psychiatric patients. Lancet, 345, 756759.CrossRefGoogle ScholarPubMed
Von Korf, M., Nestadt, G., Romanoski, A., et al (1985) Prevalence of treated and untreated DSM-III schizophrenia. Journal of Nervous and Mental Disease, 173, 577581.CrossRefGoogle Scholar
Wilkinson, G., Fallon, I. & Sen, B. (1985) Chronic mental disorders in general practice. British Medical Journal, 291, 13021304.CrossRefGoogle ScholarPubMed
Wing, J. K., Babor, T., Brugha, T., et al (1990) SCAN. Schedules for Clinical Assessment in Neuropsychiatry. Archives of General Psychiatry, 47, 589593.CrossRefGoogle ScholarPubMed
World Health Organization (1992) Tenth Revision of the International Classification of Diseases and Related Health Problems. Clinical Descriptions and Diagnostic Guidelines. Geneva: WHO.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, 111.CrossRefGoogle ScholarPubMed
Wykes, T. & Sturt, E. 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.CrossRefGoogle ScholarPubMed
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