Psychotic DisordersNCT04695132
Illness Management and Recovery- a Cluster Randomized Controlled Trial Within a Forensic Mental Inpatient Setting
A study testing Illness Management and Recovery treatment programme in people with Psychotic Disorders and Forensic Psychology, run by Karolinska Institutet at 1 site in Sweden.
Trial summary
The purpose of the study is to investigate the effects of a psychoeducational intervention program, Illness Management and Recovery (henceforth abbreviated as IMR), when administered to inpatient forensic mental health patients. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Psychotic Disorders, Forensic Psychology, Forensic Nursing
- What is being tested?
- Illness Management and Recovery treatment programme
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 30 participants
- Where
- 1 siteSweden
- Study dates
- 1 Oct 2021to 1 Feb 2024
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Recipient of court mandated forensic mental health care following conviction of crime and diagnosis of serious mental illness
- Deemed capable of giving informed consent to research by treating medical staff
Who cannot join
- Recipient of treatment for other reason than court mandated care (e.g., recipients of prison sentences receiving temporary mental health treatment, patients receiving compulsory mental care without previous conviction of crime)
- Deemed uncapable or unwilling to give informed consent
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Illness Management and Recovery- en behandlingsutvärdering Inom rättspsykiatrin.
The purpose of the study is to investigate the effects of a psychoeducational intervention program, Illness Management and Recovery (henceforth abbreviated as IMR), when administered to inpatient forensic mental health patients. IMR is a treatment program that can be administered in both a group and an individual format. It is designed for persons suffering from severe mental health problems and has two principal aims: 1. promoting participants´ capacity to manage and alleviate symptoms and functional impairment and 2. helping participants in formulating and attaining subjectively meaningful recovery goals. Forensic mental health inpatients receiving this treatment will be compared to patients who receive treatment as usual on a variety of outcome measures, such as clinician and self-rated levels of symptoms, function and perceived levels of hope. Furthermore, clinicians' experiences of working with the intervention will be investigated using a structured questionnaire regarding implementation processes and through an interview protocol.
The study has 3 objectives:
- Investigating the effects of the treatment on the chosen outcome measures.
- Investigating the effects of potential moderators on treatment outcome. These moderators include: pre-treatment functional status measured by self and informant report, neuropsychological performance and pre-admission indicators of presence of criminogenic risk factors and everyday functioning.
- Investigating the experiences of staff working with the intervention, through the lense of Normalization Process Theory.
Read the detailed description
The plan is to conduct the study through a cluster-randomized approach. Recruitment will take place amongst inpatients in the Swedish forensic mental health services. The clusters of patients randomized to the two study conditions will in effect be inpatient forensic mental health wards at Swedish forensic facilities. Enrolment and randomizing of clusters will take place stepwise during the duration of the study. Inpatient wards at participating sites will be randomized to either the control or the active condition and patients at these wards will be asked to give informed consent before participating in the study. After training, the staff at these wards will administer IMR to patients during two group sessions and one individual session a week. The IMR treatment administered consist of 10 chapters containing information and exercises pertaining to subjects relevant to mental health and recovery, such as medication use, social support, problem solving, etc. Translation of the original IMR-manual into Swedish and adaptions to the forensic mental health setting was done with permission from the original developers and authors of the treatment protocol. Study participants at control wards will receive treatment as usual. Data collection takes place at four times during the study (before start of treatment, four months into treatment, post treatment and during a three month follow-up). During data collection, participants fill in self-report measurements of symptom levels, functional impairment and perceived hope. Clinicians with good knowledge of participants also complete informant questionnaires on perceived levels of patient symptoms and functioning. During the data collection that takes place before treatment, participants also complete a neuropsychological test ("Zoo park" from the Behavioral assessment of dysexecutive syndrome, BADS). Anamnestic data pertaining to the pre-admission functioning and criminal history of the patients in the active condition will also be collected from the patient files. The data collection mentioned in the previous two sentences will be done to investigate potential moderators of treatment outcomes.
The outcome measures used in the study are WHODAS 2.0 (World Health Organization Disability Schedule 2.0 self-report and informant versions), IMRs (Illness management and Recovery treatment scale, self-report and informant versions), HoNOS-S (Health of Nation Outcome Scale-Secure version) and ASHS (Adult State Hope Scale). During the data collection four months into treatment, only IMRs and ASHS is completed, whereas all outcome scales are completed during the other data collection points. During the data collection post-treatment, treatment participants also complete CSQ-8 (Client Satisfaction Questionnaire-8).
The experiences of the staff administrating the treatment also will be investigated, with the purpose of exploring the process of implementing the intervention in this setting. This will be done using the Swedish version of the NoMAD-questionnaire (Normalization Process Theory Measure), which is a tool developed to operationalize the theoretical framework of Normalization Process Theory. The staff will complete this questionnaire after receiving training in the intervention, three months after treatment commencement and during a follow-up a year after treatment commencement. During the latter two of these data collection points staff will also be interviewed in a semi-structured fashion, using the questions in the NoMAD-questionnaire as a starting point for collection of more in depth qualitative data on the implementation of IMR. The part of the study pertaining to staff experiences of working with IMR are exploratory in character and we do not consider NoMAD to be a measure of treatment outcome.
As mentioned above, certain anamnestic data and neuropsychological performance (measured by the Zoo-map subtest), will be collected and analyzed as potential moderators of treatment outcome. The pre-treatment self and informant-report of everyday functioning (measured by WHODAS 2.0) will also be analyzed as a potential moderator of treatment effects on the other outcome measures. Of special interest in this regard will be discrepancies between the participants´ self reported functional status (assessed by WHODAS 2.0 self report) and other measures of functional status (informant version of WHODAS 2.0, performance on the Zoo map-test and anamnestic indicators of functioning). This interest is motivated by previous research indicating that overestimation of own abilities play a part in predicting outcomes for schizophrenia spectrum patients.
- Conditions
- Psychotic Disorders, Forensic Psychology, Forensic Nursing, Antisocial Personality Disorder, Substance Use Disorders
- Being tested
- Illness Management and Recovery treatment programme
- Medical subject headings
- Psychotic Disorders, Antisocial Personality Disorder, Substance-Related Disorders
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Illness Management and Recovery treatment programmeBehavioural
The Illness Management and Recovery treatment programme is a psychosocial treatment aimed at attaining illness management skills and promoting a sense of personal recovery amongst patients with serious mental illness. The original treatment protocol has been translated to Swedish and adapted to a forensic mental health setting. The treatment consists of ten chapters containing information and practical exercises relating to topics relevant for mental health and mental health recovery. These topics include medication use, stress reduction, problem solving, recovery goals and navigating the forensic mental health system. Participants are assigned practical homework and tasks to be completed outside of treatment sessions. Group sessions are conducted to present and discuss treatment material. Individual sessions are used to rehearse treatment content, personalize the treatment and review progress in achieving tasks agreed upon in the group setting.
| Study group | Role | What they receive |
|---|---|---|
| Illness Management and Recovery treatment programme (intervention group) | Experimental | These patients receive the Illness Management and Recovery treatment. Treatment takes place during 2 Group sessions and 1 individual session per week. Receives: Behavioral: Illness Management and Recovery treatment programme |
| Treatment as usual (control group) | No intervention | These patients receive treatment as usual consisting of the standard treatment given at the respective inpatient forensic mental health facility where they are admitted. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Health of Nation Outcome Scale-Secure version (HoNOS-S) (change from baseline levels to post treatment, estimated approximately 9 months after baseline).
An informant rating scale answered by the participants treating psychiatrists. The scale provides information on informant assessment of the participants level of symptom burden, functioning and the perceived need of special security measures in the care of the patient. The scale consists of a total of 19 items, 12 pertaining to clinical factors regarding perceived symptom burden and level of functioning and 7 pertaining to the perceived necessity of security arrangements associated with the care of the individual participant/patient.
Measured: This comparison will be made between HoNOS ratings in treatment and control group taken before treatment commencement and directly following treatment completion (estimated 9 months in between)
World Health Organizations Disability Assessment Schedule 2.0 36-item version, interview administered. (change from baseline levels to post treatment estimated 9 months after baseline).
An interviewed schedule designed to measure the respondents health and level of disability. Measures this in six subdomains (cognition, mobility, personal care, relations, daily activities and participation). Research participants are interviewed with this assessment schedule.
Measured: This comparison will be made between WHODAS ratings in treatment and control group taken before treatment commencement and directly following treatment completion (estimated 9 months in between)
Secondary outcomes (13)
Illness Management and Recovery Scale-Self report version (change from baseline to measure taken 4 months after treatment start)
A questionnaire designed to measure progress towards the goals stipulated in Illness Management and Recovery. The questionnaire contains 15 items answered on a scale from 1-5. Items include queries on the respondents self-assessment of own level of knowledge regarding mental illness, their access to social support and the presence of a clear plan for illness management.
Measured: Control and active group´s change scores between baseline measure and 4-months after treatment commencement will be compared.
Illness Management and Recovery Scale-Self report version (change from baseline to post-treatment completion, estimated 9 months in between).
A questionnaire designed to measure progress towards the goals stipulated in Illness Management and Recovery. The questionnaire contains 15 items answered on a scale from 1-5. Items include queries on the respondents self-assessment of own level of knowledge regarding mental illness, their access to social support and the presence of a clear plan for illness management.
Measured: Control and active group´s change scores between baseline measure and treatment completion (estimated to 9 months in between) will be compared.
Illness Management and Recovery Scale-Self report version (change from baseline to 3 months follow up after treatment completion, estimated time 12 months in between).
A questionnaire designed to measure progress towards the goals stipulated in Illness Management and Recovery. The questionnaire contains 15 items answered on a scale from 1-5. Items include queries on the respondents self-assessment of own level of knowledge regarding mental illness, their access to social support and the presence of a clear plan for illness management.
Measured: Control and active group´s change scores between baseline measure and follow up 3 months after treatment completion (estimated time 12-months between the measures) will be compared.
Illness Management and Recovery Scale- Clinician administered version (change from baseline to follow up 4 months after treatment start)
A questionnaire designed to measure progress towards the goals stipulated in Illness Management and Recovery. The questionnaire contains 15 items answered on a scale from 1-5. This version is administered to a clinician with good knowledge of the research participant. Items include queries on the respondents assessment of the participants level of knowledge regarding mental illness, their access to social support and the presence of a clear plan for illness management.
Measured: Control and active group´s change scores between baseline measure and 4-months after treatment commencement will be compared.
Illness Management and Recovery Scale- Clinician administered version (change from baseline to post-treatment completion, estimated 9 months in between).
A questionnaire designed to measure progress towards the goals stipulated in Illness Management and Recovery. The questionnaire contains 15 items answered on a scale from 1-5. This version is administered to a clinician with good knowledge of the research participant. Items include queries on the respondents assessment of the participants level of knowledge regarding mental illness, their access to social support and the presence of a clear plan for illness management.
Measured: Control and active group´s change scores between baseline measure and treatment completion (estimated to 9 months in between) will be compared.
Illness Management and Recovery Scale- Clinician administered version (change from baseline to 3 months follow up after treatment completion, estimated time 12 months in between).
A questionnaire designed to measure progress towards the goals stipulated in Illness Management and Recovery. The questionnaire contains 15 items answered on a scale from 1-5. This version is administered to a clinician with good knowledge of the research participant. Items include queries on the respondents assessment of the participants level of knowledge regarding mental illness, their access to social support and the presence of a clear plan for illness management.
Measured: Control and active group´s change scores between baseline measure and follow up 3 months after treatment completion (estimated time 12-months between the measures) will be compared.
World Health Organizations Disability Assessment Schedule 2.0 36-item version, proxy administered, change between baseline and measure taken after treatment completion (estimated 9 months in between the two measures)
A proxy administered version of WHODAS designed with the same purpose as the interview version: to assess a persons health and level of disability, in this version by posing questions regarding this to a proxy informant. Measures this in six subdomains (cognition, mobility, personal care, relations, daily activities and participation). Care staff with good knowledge of research participants answer this questionnaire.
Measured: Change scores on the proxy version of WHODAS from baseline measure to a measure taken after treatment completion (estimated 9 months in between) will be compared between active and control group.
World Health Organizations Disability Assessment Schedule 2.0 36-item version, proxy administered (change from baseline to 3 months follow up after treatment completion, estimated time 12 months in between).
A proxy administered version of WHODAS designed with the same purpose as the interview version: to assess a persons health and level of disability, in this version by posing questions regarding this to a proxy informant. Measures this in six subdomains (cognition, mobility, personal care, relations, daily activities and participation). Care staff with good knowledge of research participants answer this questionnaire.
Measured: This comparison will be made between scores for control and active group on proxy measures of WHODAS at baseline and a 3 months follow up after completion (i.e. approx. 12 months after baseline measure at treatment start)
Adult State Hope Scale (ASHS) (change from baseline to measure taken 4 months after treatment start)
A self-rating instrument designed to measure the respondents level of hope by 6-items answered on a 8-point scale.
Measured: Control and active group´s change scores between baseline measure and 4-months after treatment commencement will be compared.
Adult State Hope Scale (ASHS) (change from baseline to post-treatment completion, estimated 9 months in between).
A self-rating instrument designed to measure the respondents level of hope by 6-items answered on a 8-point scale.
Measured: Control and active group´s change scores between baseline measure and treatment completion (estimated to 9 months in between) will be compared.
Adult State Hope Scale (ASHS) (change from baseline to 3 months follow up after treatment completion, estimated time 12 months in between).
A self-rating instrument designed to measure the respondents level of hope by 6-items answered on a 8-point scale.
Measured: Control and active group´s change scores between baseline measure and follow up 3 months after treatment completion (estimated time 12-months between the measures) will be compared.
World Health Organizations Disability Assessment Schedule 2.0 36-item version, interview administered. (change from baseline to 3 months follow up after treatment completion, estimated time 12 months in between).
An interviewed schedule designed to measure the respondents health and level of disability. Measures this in six subdomains (cognition, mobility, personal care, relations, daily activities and participation). Research participants are interviewed with this assessment schedule.
Measured: This comparison will be made between WHODAS ratings in treatment and control group taken at baseline and a 3 months follow up after treatment completion (i.e. approx. 12 months after treatment start)
Health of Nation Outcome Scale-Secure version (HoNOS-S) (change from baseline to 3 months follow up after treatment completion, estimated time 12 months in between).
An informant rating scale answered by the participants treating psychiatrists. The scale provides information on informant assessment of the participants level of symptom burden, functioning and the perceived need of special security measures in the care of the patient. The scale consists of a total of 19 items, 12 pertaining to clinical factors regarding perceived symptom burden and level of functioning and 7 pertaining to the perceived necessity of security arrangements associated with the care of the individual participant/patient.
Measured: This comparison will be made between HONOS ratings in treatment and control group taken at baseline and a 3 months follow up after treatment completion (i.e. approx. 12 months after treatment start)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 Jan 2021
- Study start1 Oct 2021
- Primary completion1 Feb 2024 (estimated)
- Study completion1 Feb 2024 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Psychotic DisordersStudies of the same condition, open and under way.
- More trials run by Karolinska InstitutetThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants will be assigned to one of two arms: Active treatment arm (recipients of Illness Management and Recovery) and Control condition (TAU). Participants in the Control condition will be offered Illness Management and Recovery after study completion, conditional on them still being treated at the forensic inpatient treatment sites that are part of the study. Participants will be recruited in clusters (consisting of wards at inpatient treatment sites) and enrollment of new clusters will take place continually during data collection.
- Masking
- None (open label)
- Enrolment
- 30 participants (actual)
Sponsor and investigators
- Lead sponsor
- Karolinska Institutet
- Sponsor type
- University, hospital or other
- Collaborators
- Dalarna County Council, Sweden
- Responsible party
- Principal investigator, Knut Sturidsson, Karolinska Institutet
- Investigators
- Knut Sturidsson, PhD, Principal investigator, Karolinska Institutet
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04695132
- Sponsor's protocol ID
- 20211805
- Status last verified
- Oct 2023
- First submitted
- 23 Nov 2020
- Last updated
- 5 Oct 2023
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Andersson P, Tistad M, Eriksson A, Enebrink P, Sturidsson K. Implementation and evaluation of Illness Management and Recovery (IMR) in mandated forensic psychiatric care - Study protocol for a multicenter cluster randomized trial. Contemp Clin Trials Commun. 2022 Mar 9;27:100907. doi: 10.1016/j.conctc.2022.100907. eCollection 2022 Jun.
PubMed 35499065
Study at a glance
From the registry record, last updated by the sponsor on 5 Oct 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Illness Management and Recovery- en behandlingsutvärdering Inom rättspsykiatrin.
- ClinicalTrials.gov ID
- NCT04695132
- Acronym / sponsor ID
- 20211805
- Conditions
- Psychotic Disorders, Forensic Psychology, Forensic Nursing, Antisocial Personality Disorder, Substance Use Disorders
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 30 participants (actual)
- Lead sponsor
- Karolinska InstitutetUniversity, hospital or other
- Collaborators
- Dalarna County Council, Sweden
- Study start
- 1 Oct 2021 (actual)
- Primary completion
- 1 Feb 2024 (estimated)
- Study completion
- 1 Feb 2024 (estimated)
- First posted
- 5 Jan 2021 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of the study is to investigate the effects of a psychoeducational intervention program, Illness Management and Recovery (henceforth abbreviated as IMR), when administered to inpatient forensic mental health patients. IMR is a treatment program that can be administered in both a group and an individual format. It is designed for persons suffering from severe mental health problems and has two principal aims: 1. promoting participants´ capacity to manage and alleviate symptoms and functional impairment and 2. helping participants in formulating and attaining subjectively meaningful recovery goals. Forensic mental health inpatients receiving this treatment will be compared to patients who receive treatment as usual on a variety of outcome measures, such as clinician and self-rated levels of symptoms, function and perceived levels of hope. Furthermore, clinicians' experiences of working with the intervention will be investigated using a structured questionnaire regarding implementation processes and through an interview protocol.
The study has 3 objectives:
- Investigating the effects of the treatment on the chosen outcome measures.
- Investigating the effects of potential moderators on treatment outcome. These moderators include: pre-treatment functional status measured by self and informant report, neuropsychological performance and pre-admission indicators of presence of criminogenic risk factors and everyday functioning.
- Investigating the experiences of staff working with the intervention, through the lense of Normalization Process Theory.
Detailed description
The plan is to conduct the study through a cluster-randomized approach. Recruitment will take place amongst inpatients in the Swedish forensic mental health services. The clusters of patients randomized to the two study conditions will in effect be inpatient forensic mental health wards at Swedish forensic facilities. Enrolment and randomizing of clusters will take place stepwise during the duration of the study. Inpatient wards at participating sites will be randomized to either the control or the active condition and patients at these wards will be asked to give informed consent before participating in the study. After training, the staff at these wards will administer IMR to patients during two group sessions and one individual session a week. The IMR treatment administered consist of 10 chapters containing information and exercises pertaining to subjects relevant to mental health and recovery, such as medication use, social support, problem solving, etc. Translation of the original IMR-manual into Swedish and adaptions to the forensic mental health setting was done with permission from the original developers and authors of the treatment protocol. Study participants at control wards will receive treatment as usual. Data collection takes place at four times during the study (before start of treatment, four months into treatment, post treatment and during a three month follow-up). During data collection, participants fill in self-report measurements of symptom levels, functional impairment and perceived hope. Clinicians with good knowledge of participants also complete informant questionnaires on perceived levels of patient symptoms and functioning. During the data collection that takes place before treatment, participants also complete a neuropsychological test ("Zoo park" from the Behavioral assessment of dysexecutive syndrome, BADS). Anamnestic data pertaining to the pre-admission functioning and criminal history of the patients in the active condition will also be collected from the patient files. The data collection mentioned in the previous two sentences will be done to investigate potential moderators of treatment outcomes.
The outcome measures used in the study are WHODAS 2.0 (World Health Organization Disability Schedule 2.0 self-report and informant versions), IMRs (Illness management and Recovery treatment scale, self-report and informant versions), HoNOS-S (Health of Nation Outcome Scale-Secure version) and ASHS (Adult State Hope Scale). During the data collection four months into treatment, only IMRs and ASHS is completed, whereas all outcome scales are completed during the other data collection points. During the data collection post-treatment, treatment participants also complete CSQ-8 (Client Satisfaction Questionnaire-8).
The experiences of the staff administrating the treatment also will be investigated, with the purpose of exploring the process of implementing the intervention in this setting. This will be done using the Swedish version of the NoMAD-questionnaire (Normalization Process Theory Measure), which is a tool developed to operationalize the theoretical framework of Normalization Process Theory. The staff will complete this questionnaire after receiving training in the intervention, three months after treatment commencement and during a follow-up a year after treatment commencement. During the latter two of these data collection points staff will also be interviewed in a semi-structured fashion, using the questions in the NoMAD-questionnaire as a starting point for collection of more in depth qualitative data on the implementation of IMR. The part of the study pertaining to staff experiences of working with IMR are exploratory in character and we do not consider NoMAD to be a measure of treatment outcome.
As mentioned above, certain anamnestic data and neuropsychological performance (measured by the Zoo-map subtest), will be collected and analyzed as potential moderators of treatment outcome. The pre-treatment self and informant-report of everyday functioning (measured by WHODAS 2.0) will also be analyzed as a potential moderator of treatment effects on the other outcome measures. Of special interest in this regard will be discrepancies between the participants´ self reported functional status (assessed by WHODAS 2.0 self report) and other measures of functional status (informant version of WHODAS 2.0, performance on the Zoo map-test and anamnestic indicators of functioning). This interest is motivated by previous research indicating that overestimation of own abilities play a part in predicting outcomes for schizophrenia spectrum patients.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- Participants will be assigned to one of two arms: Active treatment arm (recipients of Illness Management and Recovery) and Control condition (TAU). Participants in the Control condition will be offered Illness Management and Recovery after study completion, conditional on them still being treated at the forensic inpatient treatment sites that are part of the study. Participants will be recruited in clusters (consisting of wards at inpatient treatment sites) and enrollment of new clusters will take place continually during data collection.
| Arm | Type | Receives |
|---|---|---|
| Illness Management and Recovery treatment programme (intervention group) | Experimental | Behavioral: Illness Management and Recovery treatment programmeThese patients receive the Illness Management and Recovery treatment. Treatment takes place during 2 Group sessions and 1 individual session per week. |
| Treatment as usual (control group) | No intervention | –These patients receive treatment as usual consisting of the standard treatment given at the respective inpatient forensic mental health facility where they are admitted. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- Recipient of court mandated forensic mental health care following conviction of crime and diagnosis of serious mental illness
- Deemed capable of giving informed consent to research by treating medical staff
Key exclusion criteria (2 listed)
- Recipient of treatment for other reason than court mandated care (e.g., recipients of prison sentences receiving temporary mental health treatment, patients receiving compulsory mental care without previous conviction of crime)
- Deemed uncapable or unwilling to give informed consent
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Illness Management and Recovery treatment programmeThe Illness Management and Recovery treatment programme is a psychosocial treatment aimed at attaining illness management skills and promoting a sense of personal recovery amongst patients with serious mental illness. The original treatment protocol has been translated to Swedish and adapted to a forensic mental health setting. The treatment consists of ten chapters containing information and practical exercises relating to topics relevant for mental health and mental health recovery. These topics include medication use, stress reduction, problem solving, recovery goals and navigating the forensic mental health system. Participants are assigned practical homework and tasks to be completed outside of treatment sessions. Group sessions are conducted to present and discuss treatment material. Individual sessions are used to rehearse treatment content, personalize the treatment and review progress in achieving tasks agreed upon in the group setting. | Behavioural | Illness Management and Recovery treatment programme (intervention group) |
Primary outcome
Health of Nation Outcome Scale-Secure version (HoNOS-S) (change from baseline levels to post treatment, estimated approximately 9 months after baseline).
Time frame: This comparison will be made between HoNOS ratings in treatment and control group taken before treatment commencement and directly following treatment completion (estimated 9 months in between)
An informant rating scale answered by the participants treating psychiatrists. The scale provides information on informant assessment of the participants level of symptom burden, functioning and the perceived need of special security measures in the care of the patient. The scale consists of a total of 19 items, 12 pertaining to clinical factors regarding perceived symptom burden and level of functioning and 7 pertaining to the perceived necessity of security arrangements associated with the care of the individual participant/patient.
World Health Organizations Disability Assessment Schedule 2.0 36-item version, interview administered. (change from baseline levels to post treatment estimated 9 months after baseline).
Time frame: This comparison will be made between WHODAS ratings in treatment and control group taken before treatment commencement and directly following treatment completion (estimated 9 months in between)
An interviewed schedule designed to measure the respondents health and level of disability. Measures this in six subdomains (cognition, mobility, personal care, relations, daily activities and participation). Research participants are interviewed with this assessment schedule.
13 secondary outcomes
Illness Management and Recovery Scale-Self report version (change from baseline to measure taken 4 months after treatment start)
Time frame: Control and active group´s change scores between baseline measure and 4-months after treatment commencement will be compared.
Illness Management and Recovery Scale-Self report version (change from baseline to post-treatment completion, estimated 9 months in between).
Time frame: Control and active group´s change scores between baseline measure and treatment completion (estimated to 9 months in between) will be compared.
Illness Management and Recovery Scale-Self report version (change from baseline to 3 months follow up after treatment completion, estimated time 12 months in between).
Time frame: Control and active group´s change scores between baseline measure and follow up 3 months after treatment completion (estimated time 12-months between the measures) will be compared.
Illness Management and Recovery Scale- Clinician administered version (change from baseline to follow up 4 months after treatment start)
Time frame: Control and active group´s change scores between baseline measure and 4-months after treatment commencement will be compared.
Illness Management and Recovery Scale- Clinician administered version (change from baseline to post-treatment completion, estimated 9 months in between).
Time frame: Control and active group´s change scores between baseline measure and treatment completion (estimated to 9 months in between) will be compared.
Illness Management and Recovery Scale- Clinician administered version (change from baseline to 3 months follow up after treatment completion, estimated time 12 months in between).
Time frame: Control and active group´s change scores between baseline measure and follow up 3 months after treatment completion (estimated time 12-months between the measures) will be compared.
World Health Organizations Disability Assessment Schedule 2.0 36-item version, proxy administered, change between baseline and measure taken after treatment completion (estimated 9 months in between the two measures)
Time frame: Change scores on the proxy version of WHODAS from baseline measure to a measure taken after treatment completion (estimated 9 months in between) will be compared between active and control group.
World Health Organizations Disability Assessment Schedule 2.0 36-item version, proxy administered (change from baseline to 3 months follow up after treatment completion, estimated time 12 months in between).
Time frame: This comparison will be made between scores for control and active group on proxy measures of WHODAS at baseline and a 3 months follow up after completion (i.e. approx. 12 months after baseline measure at treatment start)
Adult State Hope Scale (ASHS) (change from baseline to measure taken 4 months after treatment start)
Time frame: Control and active group´s change scores between baseline measure and 4-months after treatment commencement will be compared.
Adult State Hope Scale (ASHS) (change from baseline to post-treatment completion, estimated 9 months in between).
Time frame: Control and active group´s change scores between baseline measure and treatment completion (estimated to 9 months in between) will be compared.
Adult State Hope Scale (ASHS) (change from baseline to 3 months follow up after treatment completion, estimated time 12 months in between).
Time frame: Control and active group´s change scores between baseline measure and follow up 3 months after treatment completion (estimated time 12-months between the measures) will be compared.
World Health Organizations Disability Assessment Schedule 2.0 36-item version, interview administered. (change from baseline to 3 months follow up after treatment completion, estimated time 12 months in between).
Time frame: This comparison will be made between WHODAS ratings in treatment and control group taken at baseline and a 3 months follow up after treatment completion (i.e. approx. 12 months after treatment start)
Health of Nation Outcome Scale-Secure version (HoNOS-S) (change from baseline to 3 months follow up after treatment completion, estimated time 12 months in between).
Time frame: This comparison will be made between HONOS ratings in treatment and control group taken at baseline and a 3 months follow up after treatment completion (i.e. approx. 12 months after treatment start)
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Oct 2023.
- Derived from this study: PubMed 35499065Andersson P, Tistad M, Eriksson A, Enebrink P, Sturidsson K. Implementation and evaluation of Illness Management and Recovery (IMR) in mandated forensic psychiatric care - Study protocol for a multicenter cluster randomized trial. Contemp Clin Trials Commun. 2022 Mar 9;27:100907. doi: 10.1016/j.conctc.2022.100907. eCollection 2022 Jun.
- Individual participant dataSharing planned: No
Related trials for Psychotic Disorders
RecruitingPhase 2
Study to Evaluate the Safety and Efficacy of Ublituximab in Participants With Schizophrenia
Schizophrenia
RecruitingPhase 3
Relapse Prevention Trial Evaluating KarXT Treatment in Schizophrenia
Schizophrenia
Recruiting
Magnetic Seizure Therapy for Schizophrenia - Trial
Treatment Resistant Schizophrenia, Schizophrenia
RecruitingObservational study
Sensory Profile and Early Clinical Signs of Calm Room Users
Psychotic Disorders, Personality Disorders
Not yet recruitingObservational study
Validation of Wearable Core Body Temperature-Based Circadian Rhythm Digital Biomarkers
Mood Disorders, Major Depressive Diorder
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Knut Sturidsson, PhD principal investigator
Karolinska Institutet
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Illness Management and Recovery treatment programme in people with Psychotic Disorders and Forensic Psychology, run by Karolinska Institutet at 1 site in Sweden.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 5 Oct 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Health of Nation Outcome Scale-Secure version (HoNOS-S) (change from baseline levels to post treatment, estimated approximately 9 months after baseline). (time frame: This comparison will be made between HoNOS ratings in treatment and control group taken before treatment commencement and directly following treatment completion (estimated 9 months in between)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04695132, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Oct 2023.