Background
Methods
Study design
Setting
Sample
Data collection
Measures
Approval from authorities and contributions from user groups
Data analysis
Results
Variables | Total sample | Significance of the differences between teams |
---|---|---|
Patient characteristics | ||
Age (years), mean (SD) | 40.1 (15.1) | 0.066 |
Sex: n (%) female | 396 (58.8) | 0.507 |
Living alone: n (%) | 396 (58.2) | <0.001** |
Currently employed: n (%) | 175 (25.7) | 0.006** |
Previous mental health service contact: n (%) | 401 (59.0) | <0.001** |
GAF mean (SD): Symptoms | 48.4 (11.6) | <0.001** |
Functioning | 49.6 (12.6) | <0.001** |
HoNOS mean (SD): Total | 12.5 (6.26) | <0.001** |
Total symptom severity (HoNOS 1-8) | 7.6 (3.72) | <0.001** |
Suicidal: n (%) | ||
No suicidal thoughts/plans | 260 (39.8) | <0.001** |
Passive death wishes/suicidal thoughts, no concrete plans | 261 (39.9) | |
Concrete suicidal plans/self-injury, but no death intentions | 110 (16.8) | |
Self-injury/death intentions | 23 (3.5) | |
Service practices (CPPS) of the staff members
| ||
Case management: median (Q1-Q 3) | 3.42 (3.05-3.63) | 0.014** |
Out of office contact: median (Q1-Q 3) | 3.11 (2.89-3.72) | 0.001** |
Medication emphasis: median (Q1-Q 3) | 3.34 (2.96-3.53) | 0.033** |
Team model: median (Q1-Q 3) | 3.57 (3.02-4.17) | 0.001** |
Family orientation: median (Q1-Q 3) | 3.66 (3.48-3.88) | 0.018** |
Involvement: median (Q1-Q 3) | 4.44 (4.13-4.57) | 0.131 |
Team characteristics
| ||
Number of team members: mean (range) | 9.1 (4.3-19.2) | |
Individual staff member case-loads: mean (range) | 2.5 (1.1-4.8) | |
24/7 and gate-keeping function | None | |
Team operates extended hours: n (%) | 4 (50) | |
Number of teams with specialist as a full-time part of the team: n (%) | 4 (50) |
Content of treatment
Length of treatment: | ||
All patients: days (SD) range | 19.5 (24.4) 0-97 | <0.001** |
More than one consultation by a CRT: days (SD) | 29.3 (24.8) | 0.001** |
Frequency of consultations and co-operation:
| ||
One consultation by a CRT: n (%) | 225 (33.1) | <0.001** |
Consultations more than twice a week: n (%) | 50 (7.4) | <0.001** |
Doctor/psychologist participated in consultations | 375 (55.1) | <0.001** |
Inclusion of family/networks (consultations, meetings, other kinds of contact): | 350 (51.5) | <0.001** |
Collaboration with other mental health services (consultations, meetings, or other kind of contact): n (%)
| 486 (71.5) | 0.038** |
GPs | 351 (51.6) | <0.001** |
Community mental health centres | 219 (32.2) | <0.001** |
Psychiatric nurse/other professions in the municipality: | 173 (25.4) | <0.001** |
Acute in-patient wards | 144 (21.2) | <0.001** |
Unwanted incidents: n (%)
| ||
Suicide attempts | 14 (2.1) | |
Self-harm | 32 (4.7) | |
Physical attacks on others | 16 (2.4) | |
Exposed to physical attacks from others | 5 (0.7) | |
Pharmacological treatment: n (%)
| ||
Medication at the end of treatment | 316 (42.0) | <0.001** |
Antipsychotic medication: n (%) | 138 (20.9) | |
Antidepressant medication: n (%) | 181 (26.6) | |
Mood-stabilizing medication: n (%) | 72 (10.6) | |
Anxiety medication: n (%) | 83 (12.2) | |
Sleep medication: n (%) | 91 (13.4) | |
Other kind of medication: n (%) | 5 | |
Reasons for concluding treatment: n (%)
| ||
Concluded as planned | 511 (75.1) | 0.002** |
Concluded earlier than planned | 132 (19.4) | 0.016** |
Concluded later than planned | 35 (5.1) | 0.008** |
Other characteristics:
| ||
Individual care plan: n (%) | 68 (10.0) | <0.001** |
Use of coercion: n (%) | 8 (0.1) | |
Brought to CRT by the police: n (%) | 27 (4.0) |
Outcomes of crises
T1* | T2** | ||||||
---|---|---|---|---|---|---|---|
Mean | SD | Mean | SD | P | 95% CI |
d***
| |
GAF symptoms | 49.16 | 10.52 | 54.29 | 12.30 | < 0.001 | -5.87, -4.40 | -0.45 |
GAF functioning | 50.20 | 11.70 | 54.78 | 12.94 | < 0.001 | -5.32, -3.85 | -0.37 |
HoNOS total | 12.08 | 5.98 | 10.02 | 6.32 | < 0.001 | 1.65, 2.47 | 0.34 |
HoNOS symptoms | 7.25 | 3.52 | 5.72 | 3.63 | < 0.001 | 1.24, 1.82 | 0.43 |
HoNOS sos probl | 4.82 | 3.37 | 4.30 | 3.47 | < 0.001 | 0.33, 0.73 | 0.15 |
T1: n (%) score 2-4 | T2: n (%) score 2-4 | p | |
---|---|---|---|
HoNOS 1 Overactive, aggressive, or disruptive behaviour | 68 (14.9) | 47 (10.3) | 0.003 |
HoNOS 2 Non-accidental self-injury | 80 (17.6) | 39 (8.6) | <0.001 |
HoNOS 3 Problems with drinking or drug-taking | 70 (15.4) | 58 (12.7) | 0.023 |
HoNOS 6 Problems with hallucinations or delusions | 46 (10.2) | 33 (7.2) | 0.012 |
HoNOS 7 Problems with depressed mood | 326 (71.7) | 238 (52.3) | <0.001 |
HoNOS 9 Problems with relationships | 212 (46.6) | 172 (37.8) | <0.001 |
Predictors of favourable outcomes of crises
Unadjusted* | p | 95% CI | Adjusted** | p | 95% CI | |
---|---|---|---|---|---|---|
Age | -0.035 | 0.172 | -0.085, 0.015 | -0.038 | 0.147 | -0.089, 0.013 |
Sex | -1.585 | 0.040*** | -3095, -0.075 | -2.499 | 0.002*** | -4.069, -0.929 |
Single | 1.282 | 0.096 | 0.230, 2.794 | 2.019 | 0.013*** | 0.436, 3.602 |
Non-accidental self-injury | 0.718 | 0.027*** | 0.081, 1.355 | 0.820 | 0.017*** | 0.146, 1.494 |
Length of treatment | 0.068 | <0.001*** | 0.037, 0.099 | 0.068 | <0.001*** | 0.037, 0.099 |
Out-of-office focus | 0.708 | 0.038*** | -0.879, 2.295 | 2.502 | 0.016*** | 0.476, 4.528 |
Involvement focus | -2.358 | 0.164 | -5.681, 0.965 | -5.770 | 0.006*** | -9.843, -1.698 |
Currently employed | 2.078 | 0.010 | 0.491, 3.667 | |||
Consultations more than twice a week | 3.481 | 0.005 | 1.058, 5.904 | |||
Doctor/psychologist participated in consultations | 1.474 | 0.050 | -0.001, 2.950 | |||
Interaction (sex × length of treatment) | 0.029 | 0.001*** | 0.011, 0.046 | |||
Interaction (single × length of treatment) | 0.038 | <0.001*** | 0.019, 0.057 | |||
Interaction (non-accidental self-injury × length of treatment) | 0.034 | <0.001*** | 0.019, 0.050 | |||
Interaction (out-of-office focus × length of treatment) | 0.020 | <0.001*** | 0.011, 0.029 | |||
Explained variance | 13.7% |