© 2000 Evidence-Based Mental Health
Intensive case management was as effective as standard case management in severe psychotic illness
Burns T, Creed F, Fahy T, et al for the UK 700 Group. Intensive versus standard case management for severe psychotic illness: a randomised trial. Lancet 1999 Jun 26;353:2185–9.[Medline]
QUESTION: In patients with serious mental illness, is intensive case management effective and is it more effective in Afro-Caribbean patients and in severely socially disabled patients (2 preplanned subgroup analyses)?
Randomised (allocation concealed*), unblinded*, controlled trial with 2 years of follow up.
4 inner city mental health services in London and Manchester, UK.
708 patients between 18 and 65 years of age (mean age 38 y, 57% men) with a psychotic illness (diagnosis by structured examination of case notes and based on the presence of hallucinations, delusions, or thought disorder) for 
2 years. Exclusion criteria were organic brain damage or a primary diagnosis of substance abuse.
353 patients were allocated to intensive case management (10–15 patients to each case manager) and 355 patients to standard case management (30–35 patients to each case manager).
The primary outcome measure was hospital use. Secondary outcome measures were clinical symptoms and social functioning.
All analyses compared patients in their randomised groups, irrespective of the form of case management received. Hospital use did not differ between the 2 treatment groups (p=0.97) (table
).
Istituto Superiore di Sanita Roma, Italy
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