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Brief Reports   |    
Durability of the Efficacy of Integrated Care in Schizophrenia: A Five-Year Randomized Controlled Study
Ulf Ingemar Malm, M.D., Ph.D.; Bo Åke Rutger Ivarsson, M.D., Ph.D.; Peter Allebeck, M.D., Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300164
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Dr. Malm is with the Department of Psychiatry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (e-mail: ulf.malm@neuro.gu.se). Dr. Ivarsson is with the Department of Psychiatry, South Älvsborg Hospital, Borås, Sweden. Dr. Allebeck is with the Department of Social Medicine, Karolinska Institute, Stockholm.

Copyright © 2014 by the American Psychiatric Association


Objective  The aim of the study was to evaluate the durability of efficacy of the Integrated Care (IC) program in a Swedish context. The IC program is a person-centered flexible assertive community treatment approach delivered through a novel mechanism: a resource group clinical microsystem for each patient.

Methods  All patients with schizophrenia in a Gothenburg urban-sector catchment area were randomly assigned to either the IC or the Rational Rehabilitation (RR) programs. Sixty-six patients were interviewed and assessed by independent interviewers before treatment, after treatment (24 months), and at follow-up (five years). Analysis was by intention to treat.

Results  At the five-year follow-up, significant improvements were noted in social functioning and consumer satisfaction in the IC group (N=35) compared with the RR group (N=31). No patients were lost to services in either program.

Conclusions  The major finding was the durability of efficacy of the IC program.

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Table 1Measures at three time points for participants in the Integrated Care (IC) program (N=35) and the Rational Rehabilitation (RR) control group (N=31)a
Table Footer Note

a Means were compared by t tests. Effect sizes (ES) were calculated by Cohen's d.

Table Footer Note

b Possible scores on the Global Assessment of Functioning range from 0 to 100, with higher scores indicating superior function or less severe symptoms and signs.

Table Footer Note

c Possible scores range from –24 to +24, with higher scores indicating greater satisfaction with services.



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