Intellectual functioning and outcome of patients with severe psychotic illness randomised to intensive case management

Abstract

BackgroundLittle research has been carried out on the benefits of intensive case management (ICM) for people with borderline IQ and severe mental illness.AimsTo compare outcome and costs of care of patients with severe psychotic illness with borderline IQ to patients of normal IQ and to assess whether ICM is more beneficial for the former than for the latter.MethodThe study utilises data from the UK700 multi-centre randomised controlled trial of case management. The main outcome measure was the number of days spent in hospital for psychiatric reasons. Secondary outcomes were costs of care and clinical outcome.ResultsICM was significantly more beneficial for borderline-IQ patients than those of normal IQ in terms of reductions in days spent in hospital, hospital admissions, total costs and needs and increased satisfaction.ConclusionsICM appears to be a cost-effective strategy for a subgroup of patients with severe psychosis with cognitive deficits.