Annabel Sandra Mueller-Stierlin, Thomas Becker, Nils Greve, Anke Hänsel, Katrin Herder, Anne Kohlmann, Jutta Lehle, Uta Majewsky, Friedrich Meixner, Elke Prestin, Melanie Pouwels, Nadja Puschner, Sabrina Reuter, Mara Schumacher, Stefanie Wöhler, Reinhold Kilian
{"title":"一项随机对照试验的结果，该试验调查了社区干预对严重精神疾病患者赋权的有效性。","authors":"Annabel Sandra Mueller-Stierlin, Thomas Becker, Nils Greve, Anke Hänsel, Katrin Herder, Anne Kohlmann, Jutta Lehle, Uta Majewsky, Friedrich Meixner, Elke Prestin, Melanie Pouwels, Nadja Puschner, Sabrina Reuter, Mara Schumacher, Stefanie Wöhler, Reinhold Kilian","doi":"10.1007/s00127-025-02879-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The effectiveness of community mental health services with respect to enhancing empowerment among patients with severe mental illness (SMI) has rarely been investigated. In this multicenter trial the effectiveness of a community mental health intervention (acronym: GBV) added to treatment as usual (TAU) compared to TAU alone was investigated.</p><p><strong>Methods: </strong>In a randomized controlled multicenter trial with twelve sites spread across Germany, people living with SMI aged 18-82 years were investigated over 24 months. The trial was conducted from 2020 to 2023, a time period affected by the Covid-19 pandemic. The intervention was delivered by multiprofessional GBV teams based on the Functional Assertive Community Treatment (FACT) program and was supplemented by strategies that increase the degree of self-determination. The primary outcome was measured by the Assessment of Empowerment in Patients with Affective and Schizophrenic Disorders (EPAS). Difference in difference (DiD) effect sizes were estimated on an intention-to-treat basis.</p><p><strong>Results: </strong>A total of 929 persons with SMI were randomly assigned to the GBV plus TAU intervention (n = 470) or to TAU alone (n = 459). The dropout rate over 24 months amounted to 28%. DiD effect sizes over 24 months indicate significant treatment effects for empowerment (d = 0.27; 95% CI = 0.14 0.40). Serious adverse events (SAE) were reported for 15 (3.2%) participants in the GBV + TAU vs. 17 (3.7%) in the TAU group.</p><p><strong>Conclusion: </strong>The addition of GBV to TAU, for patients with SMI, can be recommended as an effective measure to improve key psychosocial outcomes in mental health care settings across Germany.</p><p><strong>Trial registration: </strong>German Clinical Trial Register, DRKS00019086. Registered on 3 January 2020, https://drks.de/search/de/trial/DRKS00019086 .</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Results from a randomized controlled trial investigating effectiveness of a community-based intervention on empowerment of people with severe mental illness.\",\"authors\":\"Annabel Sandra Mueller-Stierlin, Thomas Becker, Nils Greve, Anke Hänsel, Katrin Herder, Anne Kohlmann, Jutta Lehle, Uta Majewsky, Friedrich Meixner, Elke Prestin, Melanie Pouwels, Nadja Puschner, Sabrina Reuter, Mara Schumacher, Stefanie Wöhler, Reinhold Kilian\",\"doi\":\"10.1007/s00127-025-02879-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The effectiveness of community mental health services with respect to enhancing empowerment among patients with severe mental illness (SMI) has rarely been investigated. In this multicenter trial the effectiveness of a community mental health intervention (acronym: GBV) added to treatment as usual (TAU) compared to TAU alone was investigated.</p><p><strong>Methods: </strong>In a randomized controlled multicenter trial with twelve sites spread across Germany, people living with SMI aged 18-82 years were investigated over 24 months. The trial was conducted from 2020 to 2023, a time period affected by the Covid-19 pandemic. The intervention was delivered by multiprofessional GBV teams based on the Functional Assertive Community Treatment (FACT) program and was supplemented by strategies that increase the degree of self-determination. The primary outcome was measured by the Assessment of Empowerment in Patients with Affective and Schizophrenic Disorders (EPAS). Difference in difference (DiD) effect sizes were estimated on an intention-to-treat basis.</p><p><strong>Results: </strong>A total of 929 persons with SMI were randomly assigned to the GBV plus TAU intervention (n = 470) or to TAU alone (n = 459). The dropout rate over 24 months amounted to 28%. DiD effect sizes over 24 months indicate significant treatment effects for empowerment (d = 0.27; 95% CI = 0.14 0.40). Serious adverse events (SAE) were reported for 15 (3.2%) participants in the GBV + TAU vs. 17 (3.7%) in the TAU group.</p><p><strong>Conclusion: </strong>The addition of GBV to TAU, for patients with SMI, can be recommended as an effective measure to improve key psychosocial outcomes in mental health care settings across Germany.</p><p><strong>Trial registration: </strong>German Clinical Trial Register, DRKS00019086. Registered on 3 January 2020, https://drks.de/search/de/trial/DRKS00019086 .</p>\",\"PeriodicalId\":49510,\"journal\":{\"name\":\"Social Psychiatry and Psychiatric Epidemiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Social Psychiatry and Psychiatric Epidemiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00127-025-02879-3\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Social Psychiatry and Psychiatric Epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00127-025-02879-3","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Results from a randomized controlled trial investigating effectiveness of a community-based intervention on empowerment of people with severe mental illness.
Purpose: The effectiveness of community mental health services with respect to enhancing empowerment among patients with severe mental illness (SMI) has rarely been investigated. In this multicenter trial the effectiveness of a community mental health intervention (acronym: GBV) added to treatment as usual (TAU) compared to TAU alone was investigated.
Methods: In a randomized controlled multicenter trial with twelve sites spread across Germany, people living with SMI aged 18-82 years were investigated over 24 months. The trial was conducted from 2020 to 2023, a time period affected by the Covid-19 pandemic. The intervention was delivered by multiprofessional GBV teams based on the Functional Assertive Community Treatment (FACT) program and was supplemented by strategies that increase the degree of self-determination. The primary outcome was measured by the Assessment of Empowerment in Patients with Affective and Schizophrenic Disorders (EPAS). Difference in difference (DiD) effect sizes were estimated on an intention-to-treat basis.
Results: A total of 929 persons with SMI were randomly assigned to the GBV plus TAU intervention (n = 470) or to TAU alone (n = 459). The dropout rate over 24 months amounted to 28%. DiD effect sizes over 24 months indicate significant treatment effects for empowerment (d = 0.27; 95% CI = 0.14 0.40). Serious adverse events (SAE) were reported for 15 (3.2%) participants in the GBV + TAU vs. 17 (3.7%) in the TAU group.
Conclusion: The addition of GBV to TAU, for patients with SMI, can be recommended as an effective measure to improve key psychosocial outcomes in mental health care settings across Germany.
Trial registration: German Clinical Trial Register, DRKS00019086. Registered on 3 January 2020, https://drks.de/search/de/trial/DRKS00019086 .
期刊介绍：
Social Psychiatry and Psychiatric Epidemiology is intended to provide a medium for the prompt publication of scientific contributions concerned with all aspects of the epidemiology of psychiatric disorders - social, biological and genetic.
In addition, the journal has a particular focus on the effects of social conditions upon behaviour and the relationship between psychiatric disorders and the social environment. Contributions may be of a clinical nature provided they relate to social issues, or they may deal with specialised investigations in the fields of social psychology, sociology, anthropology, epidemiology, health service research, health economies or public mental health. We will publish papers on cross-cultural and trans-cultural themes. We do not publish case studies or small case series. While we will publish studies of reliability and validity of new instruments of interest to our readership, we will not publish articles reporting on the performance of established instruments in translation.
Both original work and review articles may be submitted.
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