Abstract：
OBJECTIVE: To determine the psychiatric hospitalizations of patients with severe schizophrenia before (standard treatment in mental health centres) and during treatment in a comprehensive, community-based, case-managed programme, as well as the role played by antipsychotic medication (oral or long-acting injectable).
METHODS: Observational, mirror image study of ten years of follow-up and ten retrospectives (\'pre-treatment\': standard), of patients with severe schizophrenia in a community-based programme, with pharmacological and psychosocial integrated treatment and intensive case management (N = 344). Reasons for discharge from the programme and psychiatric hospital admissions (and whether they were involuntary) were recorded ten years before and during treatment, as well as the antipsychotic medication prescribed.
RESULTS: The retention achieved in the programme was high: after 10 years only 12.2% of the patients were voluntary discharges vs 84.3% on previous standard treatment. The number of patients with hospital admissions, and number of admissions due to relapses decreased drastically after entering the programme (P < .0001), as well the involuntary admissions (P < .001). Being on long-acting injectable antipsychotic medication was related with these results (P < .0001).
CONCLUSIONS: Treatment of patients with severe schizophrenia in a comprehensive, community-based and case-managed programme achieved high retention rates, and was effective in drastically reducing psychiatric hospitalizations compared to the previous standard treatment in mental health units. Undergoing treatment with long-acting injectable antipsychotics was clearly linked to these outcomes.
METHODS: Observational, mirror image study of ten years of follow-up and ten retrospectives (\'pre-treatment\': standard), of patients with severe schizophrenia in a community-based programme, with pharmacological and psychosocial integrated treatment and intensive case management (N = 344). Reasons for discharge from the programme and psychiatric hospital admissions (and whether they were involuntary) were recorded ten years before and during treatment, as well as the antipsychotic medication prescribed.
RESULTS: The retention achieved in the programme was high: after 10 years only 12.2% of the patients were voluntary discharges vs 84.3% on previous standard treatment. The number of patients with hospital admissions, and number of admissions due to relapses decreased drastically after entering the programme (P < .0001), as well the involuntary admissions (P < .001). Being on long-acting injectable antipsychotic medication was related with these results (P < .0001).
CONCLUSIONS: Treatment of patients with severe schizophrenia in a comprehensive, community-based and case-managed programme achieved high retention rates, and was effective in drastically reducing psychiatric hospitalizations compared to the previous standard treatment in mental health units. Undergoing treatment with long-acting injectable antipsychotics was clearly linked to these outcomes.
摘要：
目的：全面确定重度精神分裂症患者在治疗前（在精神卫生中心进行标准治疗）和治疗期间的精神病住院情况，以社区为基础,病例管理方案，以及抗精神病药物（口服或长效注射剂）所起的作用。
方法：观察性，十年随访和十个回顾的镜像研究(“治疗前”:标准)，在一个以社区为基础的项目中，药理学和社会心理综合治疗和强化病例管理（N=344）。在治疗前十年和治疗期间记录了出院和精神病医院入院的原因(以及它们是否是非自愿的)，以及处方的抗精神病药物。
结果：在该计划中获得的保留率很高：10年后，只有12.2％的患者自愿出院，而以前的标准治疗为84.3％。住院患者的数量，进入该计划后，因复发而入院的人数急剧下降（P<0.0001），以及非自愿入院（P<0.001）。服用长效注射抗精神病药物与这些结果相关（P<0.0001）。
结论：对重度精神分裂症患者的综合治疗,基于社区和案例管理的计划实现了很高的保留率，与以前的精神卫生单位的标准治疗相比，可以有效地大幅减少精神病住院。接受长效注射抗精神病药物治疗显然与这些结果有关。
方法：观察性，十年随访和十个回顾的镜像研究(“治疗前”:标准)，在一个以社区为基础的项目中，药理学和社会心理综合治疗和强化病例管理（N=344）。在治疗前十年和治疗期间记录了出院和精神病医院入院的原因(以及它们是否是非自愿的)，以及处方的抗精神病药物。
结果：在该计划中获得的保留率很高：10年后，只有12.2％的患者自愿出院，而以前的标准治疗为84.3％。住院患者的数量，进入该计划后，因复发而入院的人数急剧下降（P<0.0001），以及非自愿入院（P<0.001）。服用长效注射抗精神病药物与这些结果相关（P<0.0001）。
结论：对重度精神分裂症患者的综合治疗,基于社区和案例管理的计划实现了很高的保留率，与以前的精神卫生单位的标准治疗相比，可以有效地大幅减少精神病住院。接受长效注射抗精神病药物治疗显然与这些结果有关。
