Home treatment (HT) is an effective treatment modality for patients with severe mental illness (SMI) in acute crisis that can often be considered equivalent to inpatient treatment in terms of treatment outcome. In Peer Support (PS) patients are supported by people with personal experiences in psychiatric crises. The current study investigates a combination of both approaches - a HT plus PS intervention - versus sole HT at different study sites throughout Germany. It is hypothesized that a peer-supported home-delivered treatment (HT plus PS) is more effective than a professional-led home-delivered treatment (HT alone) with respect to the time until hospital readmission, self-efficacy, psychosocial health, recovery orientation, internalized stigma and service satisfaction. Furthermore, it is hypothesized, that a peer-supported home delivered treatment (HT plus PS) is as effective as a professional-led home-delivered treatment (HT alone) with respect to disease severity and general functioning (secondary outcomes).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
201
After allocation participants receive a combination of Home Treatment by a multiprofessional team and Peer Support.
After allocation participants receive professional-led Home Treatment by a multiprofessional team without Peer Support (treatment as usual).
Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Vivantes Klinikum am Urban
Berlin, Germany
Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Vivantes Klinikum Neukölln
Berlin, Germany
Zentrum für Psychosoziale Medizin, Gesundheit Nord, Klinikverbund Bremen
Bremen, Germany
Bezirkskrankenhaus Donauwörth, Fachklinik für Psychiatrie, Psychotherapie und Psychosomatik an der Donau-Ries Klinik
Donauwörth, Germany
Klinik für Psychiatrie und Psychotherapie II, Günzburg, Universitätsklinikum Ulm
Günzburg, Germany
Abteilung für Psychiatrie und Psychotherapie, Asklepios Westklinikum Hamburg
Hamburg, Germany
Psychiatrische Klinik Lüneburg
Lüneburg, Germany
Abteilung für Psychiatrie, Psychotherapie und Psychosomatik, Medizinische Hochschule Brandenburg, Immanuel Klinik Rüdersdorf
Rüdersdorf, Germany
Time to first readmission to inpatient hospital treatment
Time frame: 1 year after last patient in
change from baseline in self-efficacy expectation scores as assessed by SWE at two months
SWE = Skala zur Allgemeinen Selbstwirksamkeitserwartung by Schwarzer \& Jerusalem (1999); minimum value = 10; maximum value = 40; higher scores mean a better outcome
Time frame: two months after allocation
change from baseline in self-efficacy expectation scores as assessed by SWE at six months
SWE = Skala zur Allgemeinen Selbstwirksamkeitserwartung by Schwarzer \& Jerusalem (1999); minimum value = 10; maximum value = 40; higher scores mean a better outcome
Time frame: six months after allocation
change from baseline in self-efficacy expectation scores as assessed by SWE at twelve months
SWE = Skala zur Allgemeinen Selbstwirksamkeitserwartung by Schwarzer \& Jerusalem (1999); minimum value = 10; maximum value = 40; higher scores mean a better outcome
Time frame: twelve months after allocation
change from baseline in psychosocial health scores as assessed by Health-49 at two months
Health-49 = Hamburger Module zur Erfassung allgemeiner Aspekte psychosozialer Gesundheit für die therapeutische Praxis by Rabung et al. (2009); subscales: somatoform complaints (SOM; min-max values=0-28; higher scores mean aworse outcome); depressiveness (DEP; min-max=0-24, higher values mean a worse outcome); phobic anxiety (PHO; min-max=0-20; higher values mean a worse outcome); psychological and somatoform complaints (PSB; min-max=0-72; higher values mean a worse outcome); psychological wellbeing (WOHL; min-max=0-20; higher values mean a better outcome); interactional problems (INT; min-max=0-28; higher values mean a worse outcome); self-efficacy (SELB; min-max=0-20; higher values mean a better outcome); activity and participation (A\&P; min-max=0-24; higher values mean a better outcome); social support (SOZU; min-max = 0-16; higher values mean a better outcome); social stress (SOZB, min-max=0-16; higher values mean a worse outcome)
Time frame: two months after allocation
change from baseline in psychosocial health scores as assessed by Health-49 at six months
Health-49 = Hamburger Module zur Erfassung allgemeiner Aspekte psychosozialer Gesundheit für die therapeutische Praxis by Rabung et al. (2009); subscales: somatoform complaints (SOM; min-max values=0-28; higher scores mean aworse outcome); depressiveness (DEP; min-max=0-24, higher values mean a worse outcome); phobic anxiety (PHO; min-max=0-20; higher values mean a worse outcome); psychological and somatoform complaints (PSB; min-max=0-72; higher values mean a worse outcome); psychological wellbeing (WOHL; min-max=0-20; higher values mean a better outcome); interactional problems (INT; min-max=0-28; higher values mean a worse outcome); self-efficacy (SELB; min-max=0-20; higher values mean a better outcome); activity and participation (A\&P; min-max=0-24; higher values mean a better outcome); social support (SOZU; min-max = 0-16; higher values mean a better outcome); social stress (SOZB, min-max=0-16; higher values mean a worse outcome)
Time frame: six months after allocation
change from baseline in psychosocial health scores as assessed by Health-49 at twelve months
Health-49 = Hamburger Module zur Erfassung allgemeiner Aspekte psychosozialer Gesundheit für die therapeutische Praxis by Rabung et al. (2009); subscales: somatoform complaints (SOM; min-max values=0-28; higher scores mean aworse outcome); depressiveness (DEP; min-max=0-24, higher values mean a worse outcome); phobic anxiety (PHO; min-max=0-20; higher values mean a worse outcome); psychological and somatoform complaints (PSB; min-max=0-72; higher values mean a worse outcome); psychological wellbeing (WOHL; min-max=0-20; higher values mean a better outcome); interactional problems (INT; min-max=0-28; higher values mean a worse outcome); self-efficacy (SELB; min-max=0-20; higher values mean a better outcome); activity and participation (A\&P; min-max=0-24; higher values mean a better outcome); social support (SOZU; min-max = 0-16; higher values mean a better outcome); social stress (SOZB, min-max=0-16; higher values mean a worse outcome)
Time frame: twelve months after allocation
means in recovery support scores as assessed by Brief INSPIRE at two months
Brief INSPIRE is a short version of INSPIRE by Williams et al. (2015); minimum value = 0; maximum value = 100; higher scores mean a better outcome
Time frame: two months after allocation
means in recovery support scores as assessed by Brief INSPIRE at six months
Brief INSPIRE is a short version of INSPIRE by Williams et al. (2015); minimum value = 0; maximum value = 100; higher scores mean a better outcome
Time frame: six months after allocation
means in recovery support scores as assessed by Brief INSPIRE at twelve months
Brief INSPIRE is a short version of INSPIRE by Williams et al. (2015); minimum value = 0; maximum value = 100; higher scores mean a better outcome
Time frame: twelve months after allocation
change from baseline in stigma resistance scores as assessed by ISMI at two months
ISMI = Internalized Stigma of Mental Illness Inventory by Sibitz et al. (2013); subscale stigma resistance; minimum value: 5; maximum value = 20; higher scores mean a better outcome
Time frame: two months after allocation
change from baseline in stigma resistance scores as assessed by ISMI at six months
ISMI = Internalized Stigma of Mental Illness Inventory by Sibitz et al. (2013); subscale stigma resistance; minimum value: 5; maximum value = 20; higher scores mean a better outcome
Time frame: six months after allocation
change from baseline in stigma resistance scores as assessed by ISMI at twelve months
ISMI = Internalized Stigma of Mental Illness Inventory by Sibitz et al. (2013); subscale stigma resistance; minimum value: 5; maximum value = 20; higher scores mean a better outcome
Time frame: twelve months after allocation
means in service satisfaction scores as assessed by ZUF-8 at two months
ZUF-8 = Fragebogen zur Messung der Patientenzufriedenheit by Schmidt et al. (1989); minimum value = 8; maximum value = 32; higher scores mean a better outcome
Time frame: two months after allocation
means in service satisfaction scores as assessed by ZUF-8 at six months
ZUF-8 = Fragebogen zur Messung der Patientenzufriedenheit by Schmidt et al. (1989); minimum value = 8; maximum value = 32; higher scores mean a better outcome
Time frame: six months after allocation
means in service satisfaction scores as assessed by ZUF-8 at twelve months
ZUF-8 = Fragebogen zur Messung der Patientenzufriedenheit by Schmidt et al. (1989); minimum value = 8; maximum value = 32; higher scores mean a better outcome
Time frame: twelve months after allocation
change from baseline in disease severity scores ay assessed by CGI at two months
CGI = clinical global impressions, see Forkmann et al., 2011; minimun value = 1; maximum value = 7; higher scores mean a worse outcome
Time frame: two months after allocation
change from baseline in disease severity scores ay assessed by CGI at six months
CGI = clinical global impressions, see Forkmann et al., 2011; minimun value = 1; maximum value = 7; higher scores mean a worse outcome
Time frame: six months after allocation
change from baseline in disease severity scores ay assessed by CGI at twelve months
CGI = clinical global impressions, see Forkmann et al., 2011; minimun value = 1; maximum value = 7; higher scores mean a worse outcome
Time frame: twelve months after allocation
change from baseline in general functioning scores as assessed by GAF at two months
GAF = Global Assessment of Functioning by Jones et al. (1995), minimum value = 0; maximum value = 100; higher scores mean a better outcome
Time frame: two months after allocation
change from baseline in general functioning scores as assessed by GAF at six months
GAF = Global Assessment of Functioning by Jones et al. (1995), minimum value = 0; maximum value = 100; higher scores mean a better outcome
Time frame: six months after allocation
change from baseline in general functioning scores as assessed by GAF at twelve months
GAF = Global Assessment of Functioning by Jones et al. (1995), minimum value = 0; maximum value = 100; higher scores mean a better outcome
Time frame: twelve months after allocation
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