Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy.
Department of Mental Health and Pathological Addiction, Azienda USL di Modena, Modena, Italy.
Early Interv Psychiatry. 2022 Mar;16(3):221-230. doi: 10.1111/eip.13145. Epub 2021 Mar 22.
Recently, there has been increasing interest in providing Personal Health Budgets (PHBs) to patients with severe mental illness. However, information on implementing PHB initiatives is still limited. Aim of this observational study was to evaluate the applicability of a PHB intervention model in a sample of Italian adults with first-episode psychosis (FEP) across a 2-year follow-up period.
Participants (n = 104; 18-50 years) were recruited within the 'Parma-Early Psychosis' program and completed the brief psychiatric rating scale (BPRS), the health of nation outcome scale (HoNOS) and the global assessment of functioning (GAF). Mixed-design analysis of variance (ANOVA) and Kaplan-Maier survival analysis (as drop-out measure) were performed.
A significant effect of time on all BPRS, HoNOS and GAF scores along the follow-up was observed in both the FEP subgroups (i.e., with [n = 49] and without [n = 55] PHB intervention). Mixed-design ANOVA results showed a significant 'time x group' interaction effects on BPRS 'Disorganization', HoNOS 'Psychiatric Symptoms' and GAF scores in FEP participants with PHB. Kaplan-Meyer survival analysis showed a longer survival mean for FEP patients with PHB.
Our results support the applicability of a PHB model within an 'Early Intervention in Psychosis' program in public community mental health services.
最近，人们越来越关注为患有严重精神疾病的患者提供个人健康预算（PHB）。然而，关于实施 PHB 计划的信息仍然有限。本观察性研究的目的是评估 PHB 干预模型在意大利首例精神病发作（FEP）患者样本中的适用性，随访时间为 2 年。
参与者（n=104；18-50 岁）在“帕尔马早期精神病学”计划中招募，并完成简明精神病评定量表（BPRS）、健康国家结局量表（HoNOS）和全面功能评估（GAF）。采用混合设计方差分析（ANOVA）和 Kaplan-Meier 生存分析（作为辍学衡量标准）进行分析。
在整个随访过程中，FEP 亚组（即接受[ n=49]和未接受[ n=55] PHB 干预）的所有 BPRS、HoNOS 和 GAF 评分均显示时间的显著影响。混合设计 ANOVA 结果显示，在接受 PHB 的 FEP 参与者中，BPRS“紊乱”、HoNOS“精神症状”和 GAF 评分存在显著的“时间 x 组”交互效应。Kaplan-Meier 生存分析显示，接受 PHB 的 FEP 患者的平均生存时间更长。
我们的研究结果支持在公共社区精神卫生服务中，在“精神病早期干预”计划中实施 PHB 模型的适用性。
