Journal Article

Illness management and recovery: one-year follow-up of a randomized controlled trial in Danish community mental health centers: long-term effects on clinical and personal recovery

Mikkelsen, John Hagel, Thomsen, Karin, Nordentoft, Merete, Kistrup, Kristen, Dalum, Helle Stentoft, Jensen, Sofie Bratberg, Korsbek, Lisa, Olander, Mette, Lindschou, Jane, Hjorthøj, Carsten, Mueser, Kim T., Eplov, Lene Falgaard

2019

Overview

Background: Illness Management and Recovery (IMR) is a curriculum-based rehabilitation program for people with severe mental illness with the short-term aim of improving illness self-management and the long-term aim of helping people achieve clinical and personal recovery. Method Participants with schizophrenia or bipolar disorders were recruited from three community mental health centers in the Capital Region of Denmark and randomized to receive group-based IMR and treatment as usual or only the usual intervention. All outcomes were assessed at baseline, postintervention, and the one-year follow-up. Long-term outcomes were categorized according to clinical recovery (i.e., symptoms, global functioning, and hospitalization) and personal recovery (i.e., hope and personal agency). Generalized linear mixed model regression analyses were used in the intent-to-treat analysis. Results A total of 198 participants were included. No significant differences were found between the IMR and control groups in the Global Assessment of Functioning one year after the intervention, nor were there significant differences in symptoms, number of hospital admissions, emergency room visits, or outpatient treatment. Conclusion The present IMR trial showed no significant effect on clinical and personal recovery at the one-year follow-up. Together with the results of other IMR studies, the present study indicates that the effect of IMR on symptom severity is unclear, which raises questions regarding the impact of IMR on functioning. Additionally, IMR did not affect personal recovery. Although more research is needed, the results indicate that the development of other interventions should be considered to help people with severe mental illness achieve a better level of functioning and personal recovery. Trial registration Trial registered at http://www.clinicaltrials.gov ( NCT01361698 ).

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Aged / Analysis / Bipolar disorder / Bipolar Disorder - rehabilitation / Care and treatment / Clinical trials / Community mental health / Community Mental Health Centers / Curricula / Curriculum / Denmark / Disease management / Emergency medical care / Emergency medical services / Evidence-based medicine / Female / Follow-Up Studies / Health facilities / Hospital admission and discharge / Humans / Illness management and recovery / Intervention / Long-term effects / Male / Medicine / Medicine & Public Health / Mental disorders / Mental Health / Mental health care / Mental health services / Mentally ill persons / Middle Aged / One-year follow-up / Psychiatry / Psychoeducation / Psychotherapy / Randomized clinical trial / Recovery (Medical) / Rehabilitation / Research Article / Schizophrenia / Schizophrenia - rehabilitation / Self care (Health) / Self-Management / Social psychiatry / therapy and provision of mental health care / Treatment Outcome / Young Adult