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Cited by 58Psychiatric care and mental health servicesSchizophrenia research and treatmentHomelessness and Social Issues

The DOI matches its Crossref record; 49 of the 51 references it cites were found in a registry or an index.

Effectiveness of integrated care including therapeutic assertive community treatment in severe schizophrenia-spectrum and bipolar I disorders: Four-year follow-up of the ACCESS II study

Open access
Schöttle, Daniel, Schimmelmann, Benno G., Ruppelt, Friederike, Bussopulos, Alexandra, Frieling, Marietta, Nika, Evangelia, Nawara, Luise Antonia, Golks, Dietmar, Kerstan, Andrea, Lange, Matthias, Schödlbauer, Michael, Daubmann, Anne, Wegscheider, Karl, Rohenkohl, Anja, Sarikaya, Gizem, Sengutta, Mary, Luedecke, Daniel, Wittmann, Linus, Ohm, Gunda, Meigel-Schleiff, Christina, Gallinat, Jürgen, Wiedemann, Klaus, Bock, Thomas, Karow, Anne, Lambert, Martin·2018·PLOS ONE
DOI 10.1371/journal.pone.0192929PMC PMC5828355
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Abstract

The ACCESS-model offers integrated care including assertive community treatment to patients with psychotic disorders. ACCESS proved more effective compared to standard care (ACCESS-I study) and was successfully implemented into clinical routine (ACCESS-II study). In this article, we report the 4-year outcomes of the ACCESS-II study. Between May 2007 and December 2013, 115 patients received continuous ACCESS-care. We hypothesized that the low 2-year disengagement and hospitalization rates and significant improvements in psychopathology, functioning, and quality of life could be sustained over 4 years. Over 4 years, only 10 patients disengaged from ACCESS. Another 23 left for practical reasons and were successfully transferred to other services. Hospitalization rates remained low (13.0% in year 3; 9.1% in year 4). Involuntary admissions decreased from 35% in the 2 years prior to ACCESS to 8% over 4 years in ACCESS. Outpatient contacts remained stably high at 2.0-2.4 per week. We detected significant improvements in psychopathology (effect size d = 0.79), illness severity (d = 1.29), level of functioning (d = 0.77), quality of life (d = 0.47) and stably high client satisfaction (d = 0.02) over 4 years. Most positive effects were observed within the first 2 years with the exception of illness severity, which further improved from year 2 to 4. Within continuous intensive 4-year ACCESS-care, sustained improvements in psychopathology, functioning, quality of life, low service disengagement and re-hospitalization rates, as well as low rates of involuntary treatment, were observed in contrast to other studies, which reported a decline in these parameters once a specific treatment model was stopped. Yet, stronger evidence to prove these results is required. TRIAL REGISTRATION: Clinical Trial Registration Number: NCT01888627.

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Crossref · 10.1371/journal.pone.0192929

Cites

49 of 49 references verified0 citation errors · 0 not checkable

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  • ACT has consistently been found across the US, UK and Europe to reduce clients' symptomology, adequately meet their needs and improve psychosocial functioning.

    “Over the years, this model of care has consistently been found across the US, UK and Europe to not only reduce clients' symptomology, but also adequately meet their needs and improve psychosocial functioning (Marshall and Lockwood 1998;Bond et al. 2001;Scho ¨ttle et al. 2018).”

    From Effect of community mental health care programs in Australia: A systematic review (2020) · cites this paper as Schöttle et al. 2018

    The Introduction reports improvements in psychopathology and functioning for patients receiving the ACCESS model, which includes ACT. But the paper studies a specific integrated-care program for patients with severe psychotic disorders; it does not establish consistent results across the US, UK and Europe or demonstrate that clients’ needs were adequately met. The Discussion’s Conclusion also says stronger evidence is needed to draw causal conclusions. (LLM, conf=0.87)

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  • Internationally, the gold standard community-based intervention for individuals with severe mental illness is ACT.

    “Internationally, the gold standard community-based intervention for individuals with severe mental illness is ACT.”

    From Effect of community mental health care programs in Australia: A systematic review (2020) · cites this paper as Schöttle et al. 2018

    The Introduction identifies ACT as an outpatient care model for people with severe mental illness and says such models have generally shown positive effects. It does not establish that ACT is internationally regarded as the gold standard among community-based interventions; the Discussion’s conclusion concerns a specific ACT-based integrated care model for psychotic disorders. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

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Citations

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1 retracted

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2 of the 51 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. H Hafner, 2013, Schizophrenia—a disorder in its own right?: results from 25 years of the ABC study, Nervenarzt, 84, 1093
  2. MB First, 2002, Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition
  3. G Juckel, 2015, Involuntary Admissions in Accordance to the Mental Health Act (PsychKG)—What are the Strongest Predictors?, Psychiatr Prax, 42, 133

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Metadata

Authors
Schöttle, D., Schimmelmann, B. G., Ruppelt, F., Bussopulos, A., Frieling, M., Nika, E., Nawara, L. A., Golks, D., Kerstan, A., Lange, M., Schödlbauer, M., Daubmann, A., Wegscheider, K., Rohenkohl, A., Sarikaya, G., Sengutta, M., Luedecke, D., Wittmann, L., Ohm, G., Meigel-Schleiff, C., Gallinat, J., Wiedemann, K., Bock, T., Karow, A., & Lambert, M.
Affiliations
  • University Medical Center Hamburg-Eppendorf (DE)
  • University of Bern (CH)
Corresponding author
Schöttle, Daniel
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2018-02-27
Volume
13
Issue
2
Pages
e0192929
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0192929
PMC
PMC5828355
OpenAlex
W2790430242
Cited by
58
References
51
Citations by year
2026: 2 · 2025: 5 · 2024: 6 · 2023: 3 · 2022: 11 · 2021: 6 · 2020: 7 · 2019: 13 · 2018: 3
FWCI
8.50
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Sociology and Political Science › Homelessness and Social Issues
Keywords
integrated care, assertive community treatment, access models, severe schizophrenia, bipolar I disorder, psychosis, long-term follow-up, hospitalization rates, involuntary admission, service disengagement, psychopathology, functioning, quality of life, client satisfaction
MeSH terms
Involuntary Treatment, Adult, Ambulatory Care, Bipolar Disorder, Community Mental Health Services, Female, Follow-Up Studies, Hospitalization, Humans, Male, Patient Dropouts, Psychotic Disorders, Quality of Life, Schizophrenia, Treatment Outcome, Patient Satisfaction, Delivery of Health Care, Integrated

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