Observer-Blind Randomized Control Trial for the Effectiveness of Intensive Case Management in Seoul: Clinical and Quality-of-Life Outcomes for Severe Mental Illness

• 발행기관: 대한신경정신의학회
• 저자명: Hye-Young Min Seung-Hee Ahn Jeung Suk Lim Hwa Yeon Seo Sung Joon Cho Seung Yeon Lee Dohhee Kim Kihoon You Hyun Seo Choi Su-Jin Yang Jee Eun Park Bong Jin Hahm Hae Woo Lee Jee Hoon Sohn
• 간행물 정보: 『Psychiatry Investigation』제22권 제5호, 513~521쪽, 전체 9쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2025.05.15

국문 초록

Objective 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). Methods 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. Results 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). Conclusion This study provides inaugural evidence on the effectiveness of S-ICM services, supporting their standardization and potential nationwide expansion.

목차

INTRODUCTION

METHODS

RESULTS

DISCUSSION

REFERENCES

키워드

Case management Community psychiatry Community mental health services Quality oflife Evidence-based practice