A Study on the Effectiveness of Community-Based Case Management Program for the First Episode Psychosis

Myung-Soo Lee; So-Ra Ahn; Na-Yoon Son; Jin-Hyeong Kim; Hee-Yeon Park; Yeon-Jung Cho

doi:10.4306/jknpa.2013.52.4.223

Journal List > J Korean Neuropsychiatr Assoc > v.52(4) > 1017634

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Lee, Ahn, Son, Kim, Park, and Cho: A Study on the Effectiveness of Community-Based Case Management Program for the First Episode Psychosis

Original Article

Journal of Korean Neuropsychiatric Association

Journal of Korean Neuropsychiatric Association 2013; 52(4): 223-230.

Published online: 31 July 2013

DOI: https://doi.org/10.4306/jknpa.2013.52.4.223

A Study on the Effectiveness of Community-Based Case Management Program for the First Episode Psychosis

Myung-Soo Lee, MD, MPH^1,², So-Ra Ahn, PRN, MPH^1,², Na-Yoon Son, MSW³, Jin-Hyeong Kim, MSW^1,², Hee-Yeon Park, BA^1,², Yeon-Jung Cho, MSW^1,²

¹Seoul Mental Health Center, Seoul, Korea.

²Yongin Mental Hospital, Yongin, Korea.

³Bombit Development Center, Seoul, Korea.

Address for correspondence: Myung-Soo Lee, MD, MPH. Seoul Mental Health Center, Yongin Mental Hospital, Ilyang B/D 5F, 6 Bongeunsa-ro 21-gil, Gangnam-gu, Seoul 135-535, Korea. Tel: +82-2-3444-9934, Fax: +82-2-3444-9961, mslee1010@hanmail.net

Received 22 February 2013 Revised 29 April 2013 Accepted 7 June 2013

Abstract

Objectives

The purpose of this study was to make empirical evidence for a community based case management program for the first episode of psychosis.

Methods

We provided a case management program for first episode psychosis patients and assessed their symptoms, function, insight, and satisfaction using Positive and Negative Syndrome Scale (PANSS), the Health of Nation Outcomes Scales (HoNOS), Scale to assess Unawareness of Mental Disorder (SUMD), Global Assessment of Functioning Scales (GAF), and Quality of Life scales (QOL) at baseline and after the program. We also evaluated the treatment maintenance rate and the changes of their developmental task achievement.

Results

Significant improvement was observed in all sub-domains of PANSS and significant changes were also observed in the areas of symptoms and function of HoNOS. Significant improvement was observed in awareness of mental illness itself and its outcomes. The treatment maintenance rate was 87.5%, including three patients who stopped their medication with the doctor's order. The rate of participation in meaningful social activities, such as school or job showed an increase, from 25% at baseline to 81% after the program.

Conclusion

Results of this study demonstrate the possibility of community programs for prevention of relapse, improvement of symptoms and function, and facilitation of return to meaningful social activities of first episode psychosis patients.

Keywords: First episode psychosis, Case management, Developmental tasks

Figures and Tables

Fig. 1

PANSS: Positive and Negative Syndrome Scale, HoNOS: Health of the Nation Outcomes Scales, SUMD: Scale to Assess Unawareness of Mental Disorder, GAF: Global Assessment of Functioning Scales.

Fig. 2

The contents and process of STEP program. STEP: Social Treatment for Early Psychosis.

Table 1

General characteristics of the subjects

Table 2

Psychiatric characteristics of the subjects

DUP: Duration of Untreated Psychosis

Table 3

Pre-post comparison by assessment tools

PANSS: Positive and Negative Syndrome Scale, HoNOS: Health of the Nation Outcomes Scales, SUMD: Scale to Assess Unawareness of Mental Disorder, GAF: Global Assessment of Functioning Scales, QOL: Quality of Life

Table 4

The education and job status changes after intervention

Notes

The authors have no financial conflicts of interest.

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