Effects of an assertive community program in patients with severe mental disorders and impact on their families
Article first published online: 25 MAY 2012
© 2012 The Authors. Psychiatry and Clinical Neurosciences © 2012 Japanese Society of Psychiatry and Neurology
Psychiatry and Clinical Neurosciences
Volume 66, Issue 4, pages 328–336, June 2012
How to Cite
Huguelet, P., Koellner, V., Boulguy, S., Nagalingum, K., Amani, S., Borras, L. and Perroud, N. (2012), Effects of an assertive community program in patients with severe mental disorders and impact on their families. Psychiatry and Clinical Neurosciences, 66: 328–336. doi: 10.1111/j.1440-1819.2012.02337.x
- Issue published online: 25 MAY 2012
- Article first published online: 25 MAY 2012
- Received 8 April 2011; revised 18 November 2011; accepted 14 March 2012.
- assertive community treatment;
- delusional disorder;
- family burden;
- predictive factors
Aims: Assertive community treatment (ACT) is known to have a positive impact on the number and length of inpatient stays. However, recent studies have shown little or no effect of such programs in European settings. This paper aims to describe the impact of a newly implemented ACT program on patients and their families' burden. Predictive factors have also been examined.
Method: Fifty-five patients characterized by heavy use of psychiatric care, numerous hospitalizations, or failure to link with outpatient psychiatric care and their relatives were followed. Data were gathered on patients before and after follow up as well as on relatives' burden and costs. The number and domains of clinician interventions have been detailed.
Results: The ACT program had a positive effect on symptoms, psychosocial adaptation and quality of life. Age was the most significant predictor of changes. Older patients, most of them suffering from delusional disorders, showed no improvement or even some impairment. Finally, the program appeared to have a marked effect on easing families' burden in domains such as assistance in daily life activities and costs.
Conclusions: ACT appears to be recommended for patients with poor outcome when treated in other settings. Early intervention seems to be justified as highlighted by younger age being the best predictor of positive changes. Families can be helped considerably, particularly those confronted with patients with persistent disturbing symptoms which do not, however, warrant hospitalization. Finally, the fact that patients with delusional disorder do not seem to improve warrants further research.