Pyschiatric advance directives effective for mental disorders

Pyschiatric advance directives effective for mental disorders

Peer worker-facilitated psychiatric advance directives (PW-PAD) are effective for decreasing compulsory hospital admissions among people with mental disorders, according to a study recently published in JAMA Psychiatry.

Aurélie Tinland, M.D., Ph.D., from Aix-Marseille University in France, and colleagues determined the efficacy of PW-PAD in in a multicenter randomized clinical trial. Adults with a diagnosis of schizophrenia, bipolar I disorder, or schizoaffective disorder who had a compulsory admission in the past 12 months were enrolled. The primary outcome was the rate of compulsory admission 12 months after randomization in 394 participants (196 assigned to the PW-PAD group and 198 to the ).

The researchers found that 27.0 and 39.9 percent of participants in the PW-PAD and control groups, respectively, had compulsory admissions. There were no significant differences observed between the groups in the rate of overall admission, therapeutic alliance score, or quality of life. Fewer symptoms, greater empowerment, and a higher recovery score were seen for participants in the PW-PAD group versus the control group (effect sizes, 0.20, 0.30, and 0.44, respectively).

"These findings support the use of PW-PADs for people with schizophrenia, bipolar I disorder, or schizoaffective disorder," the authors write. "Legal and organizational initiatives that promote supported can develop the activity of peer workers to fulfill this mission."

More information: Aurélie Tinland et al, Effect of Psychiatric Advance Directives Facilitated by Peer Workers on Compulsory Admission Among People With Mental Illness, JAMA Psychiatry (2022). DOI: 10.1001/jamapsychiatry.2022.1627

Journal information: JAMA Psychiatry

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Citation: Pyschiatric advance directives effective for mental disorders (2022, August 22) retrieved 27 March 2023 from
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