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Table 2 Effect youth-ACT on severity of psychiatric symptoms

From: The effect of youth assertive community treatment: a systematic PRISMA review

Reference Main results Psychiatric disorders in sample (%) Follow-up (months) Assessment instruments Effect sizea & 95% CIb
Adrian & Smith (2014) [46] Youth-ACT with hospital care and without hospital care was associated with reductions in severity of psychiatric symptoms. Larger effect sizes were found for psychotic symptoms, ASD and mood disorders than for self-harm, eating, and neurotic disorders Mood: 33 P-Tc HoNOSCA Reduction HoNOSCA
Sum-scores
Both groups:
Patients that needed inpatient care during ACT treatment:
Patients with only ACT:
1.2 (1.1, 1.4)
1.2 (0.9, 1.5)
1.3 (1.1, 1.5)
Anxiety: 26
Psychotic: 21
Self-harm: 12
ASD: 2
Eating: 2
Other: 10
Baier et al. (2013) [6] Youth-ACT is associated with reduction of psychiatric symptoms Psychotic: 51 P-Tc HoNOSCA Reduction HoNOSCA
Sum-scores:
Disruptive behaviour:
Hyperactivity:
Self-injury:
Substance abuse:
Hallucinations:
Non-organic:
Emotional:
1.3 (0.8, 1.8)
0.1 (−0.4, 0.5)
0.3 (−0,1, 0.8)
0.7 (0.2, 1.1)
0.2 (−0.2, 0.6)
1.0 (0.5, 1.4)
0.2 (−0.3, 0.7)
0.8 (0.3, 1.3)
Schizophrenia: 23
Mood: 14
Anxiety: 9
Conduct: 26
Godley et al. (2002) [49] Preliminary outcomes of Godley et al. (2006) [50]. Significantly more abstinent from marijuana in youth-ACT + Usual Continuing Care (UCC) group compared to only UCC Substance: 100 3 GAIN
TLFB
Urine tests
Breath-analyser
Interviews
Alcohol use:
Abstinence at follow-up:
Marijuana, 3 months:
0.1 (−0.2, 0.4)
0.4 (0.1, 0.8)
Godley et al. (2006) [50] Significantly more long-term abstinent from marijuana in youth-ACT + Usual Continuing Care (UCC) compared to only UCC Substance: 100 3, 6, 9 GAIN
TLFB
Urine tests
Breath-analyser
Interviews
Abstinence at follow-up:
Alcohol, 3 and 9 months:
Marijuana, 3 and 9 months both:
Other drugs, 3 months:
9 months:
0.1 (−0.2, 0.4)
0.3 (0.0, 0.6)
0.2 (−0.1, 0.5)
0.1 (−0.1, 0.3)
Mood: 38
Anxiety: 38
PTSD: 36
ADHD: 57
Conduct: 67
Godley et al. (2010) [51] Youth-ACT had no additional effect on substance disorders compared to outpatient treatment only Alcohol: 49 3, 6, 9, 12 GAIN substance problem scale
Urine tests
Additional effect of youth-ACT in symptom reducing 0.1 (−0.2, 0.4)
Marijuana: 75
Mood: 28
Anxiety: 8
PTSD: 19
ADHD: 34
Conduct: 42
Godley et al. (2015) [52] Significantly more long-term abstinent from marijuana and alcohol in youth-ACT compared to only Usual Continuing Care (UCC) Alcohol: 58 3, 6, 9, 12 GAIN substance problem scale
Urine tests
Breathalyzer
Abstinence at follow-up:
Alcohol: 12 months:
Marijuana: 12 months:
Other drug: 12 months:
0.3 (0.1, 0.8)
0.3 (0.0, 0.6)
0.3 (0.0, 0.6)
Marijuana: 91
Mood: 32
Anxiety: 46
PTSD: 33
ADHD: 49
Conduct: 65
McFarlane et al. (2014) [40] Youth-ACT was superior in reducing positive, negative, disorganized symptoms and general symptoms in adolescents compared to community care Substance: 8 6, 12, 24 SIPS
SCID-I/CV
Symptom reduction:
Positive symptoms:
Negative symptoms:
Disorganized:
0.6 (0.4, 0.9)
0.3 (0.0, 0.5)
0.4 (0.2, 0.7)
Mood: 42
Anxiety: 8
PTSD: 8
OCD: 7
Psychosis: 13
McGarvey et al. (2014) [41] Youth-ACT reduces marijuana use but does not reduce alcohol use Substance or co-occurring disorder: NRd 3, 6, 12 GAIN
Drug tests
Reduction in days marijuana use at follow-up:
Boys at 3 months:
6 months:
12 months:
Girls at 3 months:
6 month:
12 months:
Alcohol use:
Boys at 3 months:
12 months:
Girls at 3 months:
12 months:
0.6 (0.3, 0.9)
0.7 (0.5, 1.0)
0.6 (0.3, 0.8)
0.4 (0.1, 0.8)
0.7 (0.0, 1.1)
0.6 (0.1, 1.1)
0.2 (0.0, 0.5)
0.2 (0.0, 0.5)
0.1 (−0.4, 0.7)
0.1 (−0.4, 0.6)
Schley et al. (2008) [42] Pre-treatment compared to post-treatment showed significant reduction in suicidality and deliberate self-harm behaviour Substance: 31 P-Tc Structured audit questionnaire
developed by youth-ACT team
Suicidality:
Deliberate self-harm:
2.1 (1.4, 2.8)
2.5 (1.7, 3.3)
Mood: 40
Anxiety 22
Psychotic: 9
ADHD/Disrupt.: 38
Eating: 9
Other: 18
Urben et al. (2015) [8] Reduction in severity of psychiatric symptoms (pre-treatment compared to post-treatment) Internalizing: 36 P-Tc HoNOSCA Reduction in HoNOSCA-scores:
Externalizing scale:
Emotional scale
0.3 (−0.1, 0.5)
0.6 (−0.3, 0.8)
Externalizing: 27
Mix: 37
Urben et al. (2016) [43] Reduction in severity of psychiatric
Symptoms.
Mood: 30 3, 6, 9 HoNOSCA Reduction in HoNOSCA
Sum-scores:
Emotional scale:
0.6 (0.0, 1.2)
0.6 (0.0, 1.2)
Anxiety: 19
Conduct disorder: 17
Psychosis: 11
Personality disorder: 4
  1. a Effect sizes were computed as Cohen’s d rounded to the first decimal place. Positive effect sizes represents improvement. Small (≥ 0.2–0.5); medium (> 0.5–0.8); large (> 0.8) [44]
  2. b CI = Confidence interval
  3. c P-T = Pre-Post measurement was conducted
  4. d NR = Not reported