Predictors of decompensation among consumers of an intensive case management program

Recent work suggests that some people who have severe and persistent mental illnesses can be transferred to less intensive services without suffering ill effects. However, the factors that affect the success of such transitions remain unknown. This longitudinal study examines consumer characteristic...

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Bibliographic Details
Published in:Behavior therapy 1999, Vol.30 (3), p.453-473
Main Authors: Ryan, Carey S., Sherman, Paul S., Robinson, Debbie R.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Health care
Medical sciences
Mental disorders
Mental health
Organization of mental health. Health systems
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Social psychiatry. Ethnopsychiatry
Studies
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Summary:Recent work suggests that some people who have severe and persistent mental illnesses can be transferred to less intensive services without suffering ill effects. However, the factors that affect the success of such transitions remain unknown. This longitudinal study examines consumer characteristics and types of intensive case management services that predict decompensation. We examined the trajectories of 86 individuals in an intensive case management program after they attained the highest level of functioning, identifying three patterns: stability, immediate decline followed by improvement, and gradual decline. Number of hospitalizations prior to program entry, being judged suicidal at program entry, and greater use of psychiatric services during program participation consistently predicted decompensation. Substance abuse and psychiatric symptomatology at program entry also predicted decompensation, but did so less consistently. Predictors of differences in specific patterns of decompensation are explored.
ISSN:0005-7894
1878-1888
DOI:10.1016/S0005-7894(99)80020-3