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Hospitalisation of severely mentally ill patients with and without problematic substance use before and during Assertive Community Treatment: an observational cohort study

BACKGROUND: Co-occurring substance use increases the risk of hospitalisation in people with severe mental illness, whereas Assertive Community Treatment (ACT) generally reduces hospitalisation in patients with severe mental illness and high inpatient service use. Because the superiority of ACT over...

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Autores principales: Clausen, Hanne, Ruud, Torleif, Odden, Sigrun, Šaltytė Benth, Jūratė, Heiervang, Kristin Sverdvik, Stuen, Hanne Kilen, Killaspy, Helen, Drake, Robert E., Landheim, Anne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855443/
https://www.ncbi.nlm.nih.gov/pubmed/27145937
http://dx.doi.org/10.1186/s12888-016-0826-5
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author Clausen, Hanne
Ruud, Torleif
Odden, Sigrun
Šaltytė Benth, Jūratė
Heiervang, Kristin Sverdvik
Stuen, Hanne Kilen
Killaspy, Helen
Drake, Robert E.
Landheim, Anne
author_facet Clausen, Hanne
Ruud, Torleif
Odden, Sigrun
Šaltytė Benth, Jūratė
Heiervang, Kristin Sverdvik
Stuen, Hanne Kilen
Killaspy, Helen
Drake, Robert E.
Landheim, Anne
author_sort Clausen, Hanne
collection PubMed
description BACKGROUND: Co-occurring substance use increases the risk of hospitalisation in people with severe mental illness, whereas Assertive Community Treatment (ACT) generally reduces hospitalisation in patients with severe mental illness and high inpatient service use. Because the superiority of ACT over standard services amongst patients with problematic substance use is uncertain, the present study examined inpatient service use amongst patients with and without problematic substance use in the 2 years before and the 2 years after they enrolled into ACT teams. METHODS: This naturalistic observational study included 142 patients of 12 different ACT teams throughout Norway. The teams assessed the patients upon enrolment into ACT using clinician-rated and self-reported questionnaires. We obtained hospitalisation data from the Norwegian Patient Register for the 2 years before and the 2 years after enrolment into ACT. We used linear mixed models to assess changes in hospitalisation and to explore associations between problematic substance use and changes in hospitalisation, controlling for socio-demographic and clinical characteristics. RESULTS: A total of 84 (59 %) participants had problematic substance use upon enrolment into the ACT teams. In the 2 years after ACT enrolment both participants with and without problematic substance use experienced a reduction in total inpatient days. Those with problematic substance use also had fewer involuntary inpatient days. Exploratory analyses suggested that symptom severity and functioning level interacted with problematic substance use to influence change in total inpatient days. CONCLUSION: These findings may suggest that ACT teams successfully support people with complex mental health problems in the community, including those with problematic substance use, and thereby contribute to a reduction in inpatient service use.
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spelling pubmed-48554432016-05-05 Hospitalisation of severely mentally ill patients with and without problematic substance use before and during Assertive Community Treatment: an observational cohort study Clausen, Hanne Ruud, Torleif Odden, Sigrun Šaltytė Benth, Jūratė Heiervang, Kristin Sverdvik Stuen, Hanne Kilen Killaspy, Helen Drake, Robert E. Landheim, Anne BMC Psychiatry Research Article BACKGROUND: Co-occurring substance use increases the risk of hospitalisation in people with severe mental illness, whereas Assertive Community Treatment (ACT) generally reduces hospitalisation in patients with severe mental illness and high inpatient service use. Because the superiority of ACT over standard services amongst patients with problematic substance use is uncertain, the present study examined inpatient service use amongst patients with and without problematic substance use in the 2 years before and the 2 years after they enrolled into ACT teams. METHODS: This naturalistic observational study included 142 patients of 12 different ACT teams throughout Norway. The teams assessed the patients upon enrolment into ACT using clinician-rated and self-reported questionnaires. We obtained hospitalisation data from the Norwegian Patient Register for the 2 years before and the 2 years after enrolment into ACT. We used linear mixed models to assess changes in hospitalisation and to explore associations between problematic substance use and changes in hospitalisation, controlling for socio-demographic and clinical characteristics. RESULTS: A total of 84 (59 %) participants had problematic substance use upon enrolment into the ACT teams. In the 2 years after ACT enrolment both participants with and without problematic substance use experienced a reduction in total inpatient days. Those with problematic substance use also had fewer involuntary inpatient days. Exploratory analyses suggested that symptom severity and functioning level interacted with problematic substance use to influence change in total inpatient days. CONCLUSION: These findings may suggest that ACT teams successfully support people with complex mental health problems in the community, including those with problematic substance use, and thereby contribute to a reduction in inpatient service use. BioMed Central 2016-05-04 /pmc/articles/PMC4855443/ /pubmed/27145937 http://dx.doi.org/10.1186/s12888-016-0826-5 Text en © Clausen et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Clausen, Hanne
Ruud, Torleif
Odden, Sigrun
Šaltytė Benth, Jūratė
Heiervang, Kristin Sverdvik
Stuen, Hanne Kilen
Killaspy, Helen
Drake, Robert E.
Landheim, Anne
Hospitalisation of severely mentally ill patients with and without problematic substance use before and during Assertive Community Treatment: an observational cohort study
title Hospitalisation of severely mentally ill patients with and without problematic substance use before and during Assertive Community Treatment: an observational cohort study
title_full Hospitalisation of severely mentally ill patients with and without problematic substance use before and during Assertive Community Treatment: an observational cohort study
title_fullStr Hospitalisation of severely mentally ill patients with and without problematic substance use before and during Assertive Community Treatment: an observational cohort study
title_full_unstemmed Hospitalisation of severely mentally ill patients with and without problematic substance use before and during Assertive Community Treatment: an observational cohort study
title_short Hospitalisation of severely mentally ill patients with and without problematic substance use before and during Assertive Community Treatment: an observational cohort study
title_sort hospitalisation of severely mentally ill patients with and without problematic substance use before and during assertive community treatment: an observational cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855443/
https://www.ncbi.nlm.nih.gov/pubmed/27145937
http://dx.doi.org/10.1186/s12888-016-0826-5
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