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Longitudinal analysis of statistical and clinically significant psychosocial change following mental health rehabilitation
Maxwell, Anna Tsoutsoulis, Katrina Menon Tarur Padinjareveettil, Aparna Zivkovic, Frank Rogers, Jeffrey M.
Maxwell, Anna
Tsoutsoulis, Katrina
Menon Tarur Padinjareveettil, Aparna
Zivkovic, Frank
Rogers, Jeffrey M.
Abstract
Purpose: With appropriate mental health rehabilitation, schizophrenia is increasingly associated with reports of recovery and stability. However, there is little empirical evidence evaluating the efficacy of services delivering this care. This study evaluated the effectiveness of rehabilitation for improving psychosocial function in consumers with schizophrenia.
Methods: An electronic database of standardized assessment instruments mandated and maintained by the health service was retrospectively reviewed to extract ratings of psychosocial function, daily living skills, and mood state from consecutive admissions to an inpatient rehabilitation service. Outcomes were compared at admission, discharge, and one-year follow-up to identify statistically significant change. Individual reliable and clinically significant change was also assessed by comparison with a normative group of clients functioning independently in the community.
Results: From admission to discharge the rehabilitation group made statistically significant gains in psychosocial function and daily living skills. Improvements were reliable and clinically significant in one-quarter to one-third of individual consumers. Approximately half sustained their improvements at follow-up, although this represented only a small fraction of the overall cohort. Consumers not demonstrating gains exhibited psychometric floor effects at admission.
Conclusions: Rehabilitation can produce statistically and clinically significant immediate improvement in psychosocial function for a sub-set of consumers with elevated scores at admission. The durability of any gains is less clear, and strategies promoting longer-term maintenance are encouraged. Furthermore, currently mandated outcome measures are confounded by issues of sensitivity and reporting compliance, and exploration of alternative instruments for assessing recovery is recommended.
Keywords
clinically significant change, mental health, outcomes, psychosocial function, rehabilitation, schizophrenia
Date
2019
Type
Journal article
Journal
Disability and Rehabilitation
Book
Volume
41
Issue
24
Page Range
2927-2939
Article Number
ACU Department
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled