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Published Online: 15 December 2014

Efficacy of Aftercare Services for People With Severe Mental Disorders in Iran: A Randomized Controlled Trial

Abstract

Objectives:

This study aimed to determine whether aftercare services reduced the number of rehospitalizations and length of hospital stay among patients with severe mental disorders.

Methods:

A total of 120 patients with schizophrenia and schizoaffective or bipolar disorder between the ages of 15 and 65 were recruited from 2010 to 2012 for a randomized controlled trial. The participants were followed up for 20 months after discharge from a university-affiliated hospital in Tehran, Iran. The selection procedure was random sampling. Sixty patients received aftercare services, which included treatment follow-up, family psychoeducation, and patient social skills training, and 60 patients received treatment as usual. Number of hospitalizations and length of hospital stay were primary outcome measures, and severity of psychopathology and severity of illness were secondary outcome measures. The quantitative primary and secondary outcomes measures were compared by using repeated-measures analysis.

Results:

Three members of the control group did not complete the study. The cumulative number of hospitalizations during the follow-up period was 55 for the control group and 26 for the intervention group. Length of stay was significantly greater in the control group compared with the intervention group (rate ratio=2.38, 95% confidence interval=2.17–2.62). Psychopathology was less severe in the intervention group compared with the control group (p<.001).

Conclusions:

Aftercare services are efficacious for reducing both the need for rehospitalization and the severity of psychopathology.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services

Cover: Breakfast in the Garden, by Frederick Carl Frieseke, circa 1911. Oil on canvas, 26 x 325/16 inches. Daniel J. Terra Collection, 1987.21. Terra Foundation for American Art, Chicago/Art Resource, New York City.

Psychiatric Services
Pages: 373 - 380
PubMed: 25828982

History

Received: 18 March 2014
Revision received: 17 August 2014
Accepted: 2 September 2014
Published online: 15 December 2014
Published in print: April 01, 2015

Authors

Details

Mohammad Ghadiri Vasfi, M.D.
All of the authors are with the Iran University of Medical Sciences, Tehran, Islamic Republic of Iran, where Dr. Ghadiri Vasfi and Dr. Hajebi are with the Mental Health Research Center and the Faculty of Behavioral Sciences and Mental Health, Dr. Moradi-Lakeh is with the Department of Community Medicine, and Ms. Esmaeili and Mr. Soleimani are with the Department of Psychology in Mental Hospital. Dr. Moradi-Lakeh is also with the Institute for Health Metrics and Evaluation, Seattle, Washington. Send correspondence to Dr. Hajebi (e-mail: [email protected]).
Maziar Moradi-Lakeh, M.D., M.P.H.
All of the authors are with the Iran University of Medical Sciences, Tehran, Islamic Republic of Iran, where Dr. Ghadiri Vasfi and Dr. Hajebi are with the Mental Health Research Center and the Faculty of Behavioral Sciences and Mental Health, Dr. Moradi-Lakeh is with the Department of Community Medicine, and Ms. Esmaeili and Mr. Soleimani are with the Department of Psychology in Mental Hospital. Dr. Moradi-Lakeh is also with the Institute for Health Metrics and Evaluation, Seattle, Washington. Send correspondence to Dr. Hajebi (e-mail: [email protected]).
Nazanin Esmaeili, M.Sc.
All of the authors are with the Iran University of Medical Sciences, Tehran, Islamic Republic of Iran, where Dr. Ghadiri Vasfi and Dr. Hajebi are with the Mental Health Research Center and the Faculty of Behavioral Sciences and Mental Health, Dr. Moradi-Lakeh is with the Department of Community Medicine, and Ms. Esmaeili and Mr. Soleimani are with the Department of Psychology in Mental Hospital. Dr. Moradi-Lakeh is also with the Institute for Health Metrics and Evaluation, Seattle, Washington. Send correspondence to Dr. Hajebi (e-mail: [email protected]).
Naser Soleimani, M.Sc.
All of the authors are with the Iran University of Medical Sciences, Tehran, Islamic Republic of Iran, where Dr. Ghadiri Vasfi and Dr. Hajebi are with the Mental Health Research Center and the Faculty of Behavioral Sciences and Mental Health, Dr. Moradi-Lakeh is with the Department of Community Medicine, and Ms. Esmaeili and Mr. Soleimani are with the Department of Psychology in Mental Hospital. Dr. Moradi-Lakeh is also with the Institute for Health Metrics and Evaluation, Seattle, Washington. Send correspondence to Dr. Hajebi (e-mail: [email protected]).
Ahmad Hajebi, M.D., M.Sc.
All of the authors are with the Iran University of Medical Sciences, Tehran, Islamic Republic of Iran, where Dr. Ghadiri Vasfi and Dr. Hajebi are with the Mental Health Research Center and the Faculty of Behavioral Sciences and Mental Health, Dr. Moradi-Lakeh is with the Department of Community Medicine, and Ms. Esmaeili and Mr. Soleimani are with the Department of Psychology in Mental Hospital. Dr. Moradi-Lakeh is also with the Institute for Health Metrics and Evaluation, Seattle, Washington. Send correspondence to Dr. Hajebi (e-mail: [email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

This study was supported financially by the Mental Health Office at Iranian Ministry of Health and Medical Education through contract number 1592767 of the Tehran Institute of Psychiatry. This clinical trial is registered in the Iranian Registry of Clinical Trials (201009052557N2).

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