Illness management and recovery: one-year follow-up of a randomized controlled trial in Danish community mental health centers: long-term effects on clinical and personal recovery

Sofie Bratberg Jensen,Helle Stentoft Dalum,Kim T Mueser,Mette Olander,John Hagel Mikkelsen,Lene Falgaard Eplov,Jane Lindschou,Kristen Kistrup,Merete Nordentoft,Lisa Korsbek,Carsten Hjorthøj,Karin Thomsen

doi:10.1186/s12888-019-2048-0

Abstract

Background: Illness Management and Recovery (IMR) is a curriculum-based rehabilitation program for people with severe mental illness with the short-term aim of improving illness self-management and the long-term aim of helping people achieve clinical and personal recovery.MethodParticipants with schizophrenia or bipolar disorders were recruited from three community mental health centers in the Capital Region of Denmark and randomized to receive group-based IMR and treatment as usual or only the usual intervention. All outcomes were assessed at baseline, postintervention, and the one-year follow-up. Long-term outcomes were categorized according to clinical recovery (i.e., symptoms, global functioning, and hospitalization) and personal recovery (i.e., hope and personal agency). Generalized linear mixed model regression analyses were used in the intent-to-treat analysis.ResultsA total of 198 participants were included. No significant differences were found between the IMR and control groups in the Global Assessment of Functioning one year after the intervention, nor were there significant differences in symptoms, number of hospital admissions, emergency room visits, or outpatient treatment.ConclusionThe present IMR trial showed no significant effect on clinical and personal recovery at the one-year follow-up. Together with the results of other IMR studies, the present study indicates that the effect of IMR on symptom severity is unclear, which raises questions regarding the impact of IMR on functioning. Additionally, IMR did not affect personal recovery. Although more research is needed, the results indicate that the development of other interventions should be considered to help people with severe mental illness achieve a better level of functioning and personal recovery.Trial registrationTrial registered at http://www.clinicaltrials.gov (NCT01361698).

Highlights

Illness Management and Recovery (IMR) is a curriculum-based rehabilitation program for people with severe mental illness with the short-term aim of improving illness self-management and the long-term aim of helping people achieve clinical and personal recovery
Together with the results of other IMR studies, the present study indicates that the effect of IMR on symptom severity is unclear, which raises questions regarding the impact of IMR on functioning
More research is needed, the results indicate that the development of other interventions should be considered to help people with severe mental illness achieve a better level of functioning and personal recovery

Summary

Introduction

Illness Management and Recovery (IMR) is a curriculum-based rehabilitation program for people with severe mental illness with the short-term aim of improving illness self-management and the long-term aim of helping people achieve clinical and personal recovery. The Illness Management and Recovery (IMR) program is a manualized, curriculum-based, recovery-oriented, rehabilitation program for people with schizophrenia or a major mood disorder [1]. IMR is delivered by mental healthcare professionals with an aim of helping individuals set and pursue personal recovery goals and learn illness management skills to facilitate their attainment of these goals [1]. The IMR program is based on two theoretical models: the transtheoretical model and the stress-vulnerability model.

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