ArticleBMC psychiatry2022
A mirror-image analysis of psychiatric hospitalisations among people with severe mental illness using Independent Supported Housing.
Article in BMC psychiatry, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed, 9 citations in OpenAlex.
- Long-acting injectable antipsychotics for the treatment of bipolar disorder: evidence from mirror-image studies.Therapeutic advances in psychopharmacology · 2023Review
- Independent Supported Housing for non-homeless individuals with severe mental illness: Comparison of two effectiveness studies using a randomised controlled and an observational study design.Frontiers in psychiatry · 2022Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEvidence on the effectiveness of Independent Supported Housing (ISH) for non-homeless people with severe mental illness primarily comes from observational cohort studies, which have high risk of bias due to confounding by time-invariant sample characteristics. The present study proposes an alternative study design known from pharmacology to overcome this bias and strengthen evidence.
methodsWe conducted a retrospective mirror-image analysis with medical records of 144 ISH service users to assess the effectiveness of ISH in reducing the number and duration of hospitalisations. Outcomes occurring in equal periods before and during ISH utilisation were compared for every ISH user. Differences between the periods were tested with incidence rate ratios (IRR).
resultsIncluded service users were on average 38.2 years old, female (54%) and predominately had an affective (28.5%) or a schizophrenic or psychotic (22.9%) disorder with ISH utilisation days ranging from 36-960. Fewer admissions (IRR = 0.41, 95%-CI 0.27-0.64) and fewer person-days hospitalised (IRR = 0.38, 95%-CI 0.35-0.41) were observed during ISH utilisation compared to prior to their ISH utilisation. While the reduction in psychiatric admissions may be somewhat confounded by time-variant characteristics, the substantial reduction in hospitalised bed-bays represents at least partially an intervention effect.
conclusionsThe mirror-image study design allowed for a cost-effective investigation of ISH effectiveness in reducing hospitalisation without confounding by time-invariant sample characteristics. We provide recommendations for the design's application and suggest further research with larger samples.
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