Min Hye-Young, Ahn Seung-Hee, Lim Jeung Suk, Seo Hwa Yeon, Cho Sung Joon, Lee Seung Yeon, Kim Dohhee, You Kihoon, Choi Hyun Seo, Yang Su-Jin, Park Jee Eun, Hahm Bong Jin, Lee Hae Woo, Sohn Jee Hoon
Department of Social Welfare, Sogang University, Seoul, Republic of Korea.
Research Institute for Life and Culture, Sogang University, Seoul, Republic of Korea.
Psychiatry Investig. 2025 May;22(5):513-521. doi: 10.30773/pi.2024.0340. Epub 2025 May 15.
In South Korea, there is a significant gap in systematic, evidence-based research on intensive case management (ICM) for individuals with severe mental illness (SMI). This study aims to evaluate the effectiveness of ICM through a randomized controlled trial (RCT) comparing ICM with standard case management (non-ICM).
An RCT was conducted to assess the effectiveness of Seoul-intensive case management (S-ICM) vs. non-ICM in individuals with SMI in Seoul. A total of 78 participants were randomly assigned to either the S-ICM group (n=41) or the control group (n=37). Various clinical assessments, including the Brief Psychiatric Rating Scale (BPRS), Montgomery-Åsberg Depression Rating Scale, Health of the Nation Outcome Scale, and Clinical Global Impression-Improvement (CGI-I), along with quality-of-life measures such as the WHO Disability Assessment Schedule, WHO Quality of Life scale, and Multidimensional Scale of Perceived Social Support (MSPSS) were evaluated over a 3-month period. Statistical analyses, including analysis of covariance and logistic regression, were used to determine the effectiveness of S-ICM.
The S-ICM group had significantly lower odds of self-harm or suicidal attempts compared to the control group (adjusted odds ratio [aOR]=0.30, 95% confidence interval [CI]: 0.21-1.38). Psychiatric symptoms measured by the BPRS and perceived social support measured by the MSPSS significantly improved in the S-ICM group. The S-ICM group also had significantly higher odds of CGI-I compared to the control group (aOR=8.20, 95% CI: 2.66-25.32).
This study provides inaugural evidence on the effectiveness of S-ICM services, supporting their standardization and potential nationwide expansion.
在韩国，针对重度精神疾病（SMI）患者的强化个案管理（ICM）的系统性、循证研究存在显著差距。本研究旨在通过一项随机对照试验（RCT）评估ICM的有效性，该试验将ICM与标准个案管理（非ICM）进行比较。
开展了一项RCT，以评估首尔强化个案管理（S-ICM）与非ICM对首尔SMI患者的有效性。共有78名参与者被随机分配到S-ICM组（n = 41）或对照组（n = 37）。在3个月的时间里，对各种临床评估指标进行了评估，包括简明精神病评定量表（BPRS）、蒙哥马利-Åsberg抑郁评定量表、国家健康结果量表和临床总体印象改善量表（CGI-I），以及生活质量指标，如世界卫生组织残疾评定量表、世界卫生组织生活质量量表和多维感知社会支持量表（MSPSS）。采用协方差分析和逻辑回归等统计分析方法来确定S-ICM的有效性。
与对照组相比，S-ICM组自我伤害或自杀未遂的几率显著更低（调整后的优势比[aOR]=0.30，95%置信区间[CI]：0.21-1.38）。S-ICM组中，由BPRS测量的精神症状和由MSPSS测量的感知社会支持有显著改善。与对照组相比，S-ICM组的CGI-I几率也显著更高（aOR=8.20，95%CI：2.66-25.32）。
本研究为S-ICM服务的有效性提供了初步证据，支持其标准化以及在全国范围内的潜在推广。
