Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan.
Asahi General Hospital, Asahi, Japan.
Neuropsychopharmacol Rep. 2020 Sep;40(3):302-306. doi: 10.1002/npr2.12126. Epub 2020 Jul 16.
Since April 2020, the new Japanese mental health system has used the Intensive Case Management Screening Sheet (ICMSS) to identify patients' needs for case management services. This study aimed to examine the association between ICMSS score and service intensity and compare the magnitude of association between ICMSS score and service intensity with other scales.
We recruited patients who received case management services from a staff member in a psychiatric outpatient service, psychiatric day-care program, or outreach team based at one psychiatric hospital. Case management service needs and functioning were assessed using ICMSS, Global Assessment Functioning (GAF), and Personal and Social Performance (PSP). The case manager also documented all services received by the participant for 2 months. The association between each scale and service duration was examined. Furthermore, the magnitude of the association between each scale and service intensity was compared.
Overall, 138 participants were included in the analysis. The most common diagnosis was schizophrenia. Mean total service duration was weakly but significantly correlated with ICMSS (Spearman's ρ = 0.320), GAF (ρ = -0.198), and PSP (ρ = -0.275) scores. Poisson's regression models and postestimation testing showed that the coefficient for ICMSS score (B = 0.144; 95% CI = 0.141, 0.148) was significantly larger than the coefficients for GAF (B = -0.017, 95% CI = -0.017, -0.016, χ = 15.70, P < 0.001) and PSP (B=-0.016, 95% CI = -0.017, -0.016, χ = 14.64, P < 0.001) scores.
ICMSS may provide preliminary information on case management service needs, but the level of service should be based on the individual needs of each patient and shared decision-making between the patient and case manager.
自 2020 年 4 月以来，日本新的心理健康系统一直使用密集个案管理筛选表（ICMSS）来确定患者对个案管理服务的需求。本研究旨在探讨 ICMSS 评分与服务强度之间的关联，并比较 ICMSS 评分与服务强度与其他量表之间关联的大小。
我们招募了在一家精神病院的工作人员的精神科门诊服务、精神日间护理计划或外展团队中接受个案管理服务的患者。使用 ICMSS、总体功能评估（GAF）和个人和社会表现（PSP）评估个案管理服务需求和功能。个案经理还记录了参与者在 2 个月内接受的所有服务。检查了每个量表与服务持续时间之间的关联。此外，还比较了每个量表与服务强度之间关联的大小。
共有 138 名参与者纳入分析。最常见的诊断是精神分裂症。总服务持续时间的平均值与 ICMSS（Spearman ρ=0.320）、GAF（ρ=-0.198）和 PSP（ρ=-0.275）评分呈弱但显著相关。泊松回归模型和事后检验表明，ICMSS 评分的系数（B=0.144；95%CI=0.141，0.148）明显大于 GAF（B=-0.017，95%CI=-0.017，-0.016，χ²=15.70，P<0.001）和 PSP（B=-0.016，95%CI=-0.017，-0.016，χ²=14.64，P<0.001）评分的系数。
ICMSS 可能提供个案管理服务需求的初步信息，但服务水平应基于每个患者的个体需求和患者与个案经理之间的共同决策。
