Issakidis C, Sanderson K, Teesson M, Johnston S, Buhrich N
Clinical Research Unit for Anxiety Disorders, University of New South Wales at St Vincent's Hospital, Sydney, Australia.
Acta Psychiatr Scand. 1999 May;99(5):360-7. doi: 10.1111/j.1600-0447.1999.tb07242.x.
This study compared intensive case management (ICM) with standard clinical case management in a well-resourced community mental health service in Australia. A total of 73 severely disabled clients of an existing clinical service were randomly allocated to either ICM (caseload 10 clients per clinician) or standard case management (caseload up to 30 clients per clinician) and followed up for 12 months. A greater proportion of clients receiving ICM showed improved social functioning, these clients had fewer psychiatric hospital admissions involving police, and were more likely to engage and remain in treatment compared to those who received standard case management. Clients receiving ICM did not show a reduction in hospitalization duration or total number of episodes. It is suggested that future studies of ICM should focus on which aspects of treatment produce positive outcomes, how they can be applied to routine clinical settings, and over what period of time outcomes are sustained.
本研究在澳大利亚资源充足的社区心理健康服务机构中，对强化个案管理（ICM）与标准临床个案管理进行了比较。现有临床服务机构的73名重度残疾客户被随机分配至ICM组（每位临床医生负责10名客户）或标准个案管理组（每位临床医生负责多达30名客户），并随访12个月。与接受标准个案管理的客户相比，接受ICM的客户中有更大比例的人社交功能得到改善，这些客户涉及警方的精神病院住院次数更少，且更有可能参与并持续接受治疗。接受ICM的客户在住院时长或发作总次数上并未减少。建议未来关于ICM的研究应聚焦于治疗的哪些方面能产生积极效果、如何将这些方面应用于常规临床环境以及效果能持续多长时间。
