The Effectiveness of Assertive Community Treatment on Schizophrenic Patients
Condition: Schizophrenia
MeSH terms: Schizophrenia
Study type: Interventional

Summary: 
      Assertive community treatment (ACT) is a community-based, patient-centered, and
      rehabilitation-oriented model based on multidisciplinary service teams. It has been proved to
      be suitable for the management of patients with severe mental disorder in the community. In
      this study, we aimed to investigate the effectiveness of ACT in an urban district of Shanghai
      with a larger sample size and a 24-month duration of follow up. We hypothesized that patients
      assigned into ACT would show better improvement in psychiatric symptoms and social function.
    

Detailed description: 
      Assertive community treatment (ACT) is a community-based, patient-centered, and
      rehabilitation-oriented model based on multidisciplinary service teams. It has been proved to
      be suitable for the management of patients with severe mental disorder in the community. In
      this study, we aimed to investigate the effectiveness of ACT in an urban district of Shanghai
      with a larger sample size and a 24-month duration of follow up. We hypothesized that patients
      assigned into ACT would show better improvement in psychiatric symptoms and social
      function.The study protocol was approved by the Institutional Review Board in Shanghai Mental
      Health Center.

      Aim of the study: 1.1 To explore the effectiveness of assertive community treatment in
      patients with schizophrenia. 1.2 The patients were followed up for 24 months to explore the
      duration of ACT.

      Introduction of the study: Patients who previously diagnosed as schizophrenia according to
      International Classification of Diseases 10th Revision (ICD-10) in the psychiatric hospitals
      would receive basic public health service in the community. The selected schizophrenic
      patients were randomly assigned into intervention group and control group by a computer
      randomization algorithm. During the following 2 years, the control group received basic
      public health services in the community while the intervention group received ACT. Clinical
      assessments were conducted at baseline and every 6 months till the end of the 2-year study. A
      single-blind method was used, in which all the assessments were independently completed by
      trained psychiatrists who didn't know the grouping.The Positive and Negative Symptoms Scale
      (PANSS) and the Personal and Social Performance Scale (PSP) were measured at baseline and
      every 6 months during the study.
    

Intervention name(s): Assertive community treatment; Basic public health services.
Intervention type(s): Combination Product; Combination Product
Intervention description(s): The intervention team consisted of psychiatrists, nurses, clinical psychologists, social workers, rehabilitation teachers. The specific services provided by the team include individual service plan. Each patient got a comprehensive evaluation within one month to establish treatment goals and individual intervention plan, rehabilitation training, family intervention peer support group, individual psychological counseling and crisis intervention.; The control group received regular medical follow-up including symptom and medication evaluation, social function evaluation and physical examination after hospital discharge. The frequency was once a quarter.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Schizophrenia; Assertive community treatment; Community rehabilitation