***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives The effect of Individual Placement and Support ( IPS ) on return to work or education among people with mood or anxiety disorders is unclear , while IPS increases return to work for people with severe mental illness . We examined the effect of IPS modified for people with mood and anxiety disorders ( IPS-MA ) on return to work and education compared with services as usual ( SAU ) . Methods In a r and omised clinical superiority trial , 326 participants with mood and anxiety disorders were central ly r and omised to IPS-MA , consisting of individual mentor support and career counselling ( n=162 ) or SAU ( n=164 ) . The primary outcome was competitive employment or education at 24 months , while weeks of competitive employment or education , illness symptoms and level of functioning , and well-being were secondary outcomes . Results After 24 months , 44.4 % ( 72/162 ) of the participants receiving IPS-MA had returned to work or education compared with 37.8 % ( 62/164 ) following SAU ( OR=1.34 , 95 % CI : 0.86 to 2.10 , p=0.20 ) . We found no difference in mean number of weeks in employment or education ( IPS-MA 32.4 weeks vs SAU 26.7 weeks , p=0.14 ) , level of depression ( Hamilton Depression 6-Item Scale score IPS-MA 5.7 points vs SAU 5.0 points , p=0.12 ) , level of anxiety ( Hamilton Anxiety 6-Item Scale score IPS-MA 5.8 points vs SAU 5.1 points , p=0.17 ) , level of functioning ( Global Assessment of Functioning IPS-MA 59.1 points vs SAU 59.5 points , p=0.81 ) or well-being measured by WHO-Five Well-being Index ( IPS-MA 49.6 points vs SAU 48.5 points , p=0.83 ) at 24 months . Conclusion The modified version of IPS , IPS-MA , was not superior to SAU in supporting people with mood or anxiety disorders in return to work at 24 months . Trial registration number NCT01721824 OBJECTIVE Given the proliferation of peer-delivered services and its growing but insufficient empirical base , we undertook a r and omized trial to examine the effects of such services on individuals with severe psychiatric disabilities undergoing a civil commitment . METHOD We recruited n = 113 individuals who were civilly committed for inpatient treatment . R and omly assigned experimental participants were paired with a trained peer specialist to receive intensive 1-on-1 support to assist them with both their recovery and the conditions of their m and ated court-ordered services . Individuals in the control group were invited to receive other supportive , peer-delivered services , such as social and group educational activities , but excluding individual peer support . We assessed a variety of outcomes including social supports , quality of life , recovery , symptoms , and functioning . RESULTS Mounting a r and omized trial in this setting and with participants who were court-ordered for inpatient treatment proved challenging in terms of recruitment , service provision , retention in the intervention , and attrition from the research . Intent-to-treat analyses revealed no significant differences in outcomes by study condition . As-treated analyses comparing high- and low-use peer support groups with control group participants found significant differences favoring peer support recipients in quality of life and functioning but no differences in other study outcomes . CONCLUSIONS AND IMPLICATION S FOR PRACTICE Difficulties with ensuring the quality of the peer support in this study may be in part responsible for our failure to see more-definitive and -positive results . As the peer support specialist profession evolves , an underst and ing of its effective ingredients and mechanisms must be eluci date d to allow for more-rigorous studies . ( PsycINFO Data base BACKGROUND While effective vocational methods for gaining employment exist for people with schizophrenia and similar conditions , no evidence exists with regard to people with affective disorders . We aim ed to study the effectiveness of a newly developed Individual Enabling and Support ( IES ) model adapted for the target group and compared to traditional vocational rehabilitation ( TVR ) . METHODS An assessor-blinded r and omized controlled trial ( RCT ) with a parallel design was performed . Sixty-one participants received IES or TVR . The primary outcome was employment rate at 12-month follow-up . Secondary vocational outcomes , depression severity , and quality of life were also studied . Trial register number is IS RCT N93470551 . RESULTS  IES  was more effective for employment compared to TVR ( 42.4 % vs. 4 % ; difference 38 % , 95 % CI 0.12 - 0.55 ) . Significant group differences were present in secondary vocational outcomes ( hours and weeks employed , time to employment ) , and depression severity . The IES-group had significantly lowering in depression scores and increased quality of life scores during the intervention period . LIMITATIONS This RCT was limited by the small sample size due to restriction of recruitment to middle-sized cities within geographically diverse sites in southern Sweden . Larger trials are needed , also in primary health care and employment services setting s. CONCLUSIONS  IES  is more effective than TVR for attaining employment and improving depressive symptoms . On a societal level , IES closes the time and service gap between treatment and employment , and thus lowers sick-leave costs Purpose Stigma has been proposed to be one of the most serious obstacles to successful treatment , rehabilitation and inclusion in society of people with severe mental illness . An aspect of stigma which has been increasingly discussed is self-stigma , which refers to the internalization of negative stereotypes among people with severe mental illness . The aim of the present study was to investigate the effectiveness of a group-based anti self-stigma intervention , narrative enhancement and cognitive therapy ( NECT ) as an add-on to treatment as usual , with regard to changes in self-stigma , self-esteem , and subjective quality of life . Method After screening for eligibility 106 participants were included in a r and omized controlled trial using a wait-list control group , of which 87 completed the study . Assessment s were made at baseline , at termination of the intervention , and at a 6-month follow-up ( intervention group only ) . Results The results showed that NECT was effective in reducing self-stigma and improving self-esteem compared to treatment as usual only . No differences were shown regarding subjective quality of life . Changes shown in the intervention group at termination of intervention were stable at the 6-month follow-up . A regression analysis showed that there was a positive relationship between exposure to the intervention and reduction of self-stigma . Conclusions The conclusion of the present study is that , using a sample size with adequate power , NECT seems to be an effective intervention with regard to diminishing self-stigma and improving self-esteem , and that these improvements were stable at a 6-month follow-up . There was a distinct relationship between number of sessions attended and improvements in self-stigma and self-esteem controlling for confounding factors . This puts attention to the importance of creating a group climate which facilitate and encourage participation through the various phases of the intervention BACKGROUND This paper sets out the rationale for the PRiSM Psychosis Study , and the research design used . Nine accompanying papers present the main results . The questions addressed by the PRiSM Psychosis Study are : can the gains of experimental studies which have demonstrated benefits arising from treatment by community mental health teams be translated to routine setting s ? If so , are the benefits diluted in ordinary clinical practice ? What are the costs ? METHOD A prospect i ve nonr and omised controlled trial of two types of community mental health service , in two phases : case identification followed by patient interviews . For the case identification the research team conducted the complete ascertainment of all prevalent cases of psychosis in the two study catchment areas in the index year ( 1991 - 1992 ) . From all 514 patients with psychotic disorders thus identified , 302 were r and omly allocated for interview  , along with a key informant clinician and a carer . Interviews were under taken at two time points , two years apart . RESULTS This paper presents the socio-demographic , clinical and ethnic characteristics of the patients . CONCLUSIONS The people with psychosis interviewed for the PRiSM Psychosis Study are representative of the whole epidemiologically based patient population identified Contrary to older views , with modern treatment some or many patients with schizophrenia may show intervals of recovery . The current 15-year prospect ively design ed follow-up research comparing schizophrenia patients with other types of psychotic and nonpsychotic patients studied how many schizophrenia patients ever show intervals of recovery .  Two hundred seventy-four early young psychiatric patients from the Chicago Followup Study , including 64 schizophrenia patients , 12 schizophreniform patients , 81 other psychotic patients , and 117 nonpsychotic patients , were assessed as in patients and then reassessed 5 times over 15 years . Patients were evaluated for recovery for 1 or more years using an operational definition of recovery . Cumulatively , over the 15-year period slightly over 40 % of patients with schizophrenia showed 1 or more periods of recovery . However , schizophrenia is still a relatively poor outcome disorder , showing poorer courses than other types of psychotic and nonpsychotic disorders ( p < .001 ) . Most schizophrenia patients did not show the severe social isolation often described prior to the modern treatment era . Schizophreniform patients tended to show more favorable outcomes than schizophrenia patients . Over 50 % of the schizophrenia patients did not have a disorder that was chronic and continuous . Rather , their disorder was episodic , although for many more vulnerable and less resilient schizophrenia patients the episodes were more frequent and severe , with slower recovery OBJECTIVES We examined the longitudinal effects of a Housing First program for homeless , mentally ill individuals ' on those individuals ' consumer choice , housing stability , substance use , treatment utilization , and psychiatric symptoms . METHODS Two hundred twenty-five participants were r and omly assigned to receive housing contingent on treatment and sobriety ( control ) or to receive immediate housing without treatment prerequisites ( experimental ) . Interviews were conducted every 6 months for 24 months . RESULTS The experimental group obtained housing earlier , remained stably housed , and reported higher perceived choice . Utilization of substance abuse treatment was significantly higher for the control group , but no differences were found in substance use or psychiatric symptoms . CONCLUSIONS Participants in the Housing First program  were able to obtain and maintain independent housing without compromising psychiatric or substance abuse symptoms The purpose of this study was to determine the efficacy of a peer-led illness self-management intervention called Wellness Recovery Action Planning ( WRAP ) by comparing it with usual care . The primary outcome was reduction of psychiatric symptoms , with secondary outcomes of increased hopefulness , and enhanced quality of life ( QOL ) .  A total of 519 adults with severe and persistent mental illness were recruited from outpatient community mental health setting s in 6 Ohio communities and r and omly assigned to the 8-week intervention or a wait-list control condition . Outcomes were assessed at end of treatment and at 6-month follow-up using an intent-to-treat mixed-effects r and om regression analysis . Compared to controls , at immediate postintervention and at 6-month follow-up , WRAP participants reported : ( 1 ) significantly greater reduction over time in Brief Symptom Inventory Global Symptom Severity and Positive Symptom Total , ( 2 ) significantly greater improvement over time in hopefulness as assessed by the Hope Scale total score and subscale for goal directed hopefulness , and ( 3 ) enhanced improvement over time in QOL as assessed by the World Health Organization Quality of Life-BREF environment subscale . These results indicate that peer-delivered mental illness self-management training reduces psychiatric symptoms , enhances participants ' hopefulness , and improves their QOL over time . This confirms the importance of peer-led wellness management interventions , such as WRAP , as part of a group of evidence -based recovery-oriented services Elevated internalized stigma is common and is linked to subjective and objective outcomes for severe mental illness . The authors developed a manualized group-based intervention ( Narrative Enhancement/Cognitive Therapy ; NECT ) to address internalized stigma in severe mental illness . The purpose of the present study was to evaluate the feasibility and effectiveness of NECT . In total , 144 individuals were screened at two sites to evaluate if they met criteria for " elevated " internalized stigma ; 39 and were eligible were r and omized to NECT or to treatment as usual ( TAU )  and were assessed at baseline , posttreatment , and 3-month follow-up . Fifteen of the 21 individuals assigned to NECT were classified as " exposed " to treatment . Intent-to-treat analyses found no significant difference between the NECT and TAU groups . A comparison of exposed versus unexposed participants noted trends for exposed participants to have improved more in two aspects of self-stigma as well as insight . We conclude that NECT is feasible and tolerable , but findings did not support the hypothesis that NECT was more effective than TAU , although small sample size and significant dropout may have restricted the ability to detect an effect OBJECTIVE This study compared the quality of treatment relationships and engagement in peer-based and regular case management . It also assessed the value of positive relationship qualities in predicting motivation for and use of community-based services for persons with severe mental illness . METHODS One hundred thirty-seven adults with severe mental illness participated in a 2x2 prospect i ve longitudinal r and omized clinical trial with two levels of case management intervention ( peer and regular ) and two interviews ( six and 12 months ) . Self-report question naires assessed treatment relationships , motivation , and service use , and providers rated participants ' initial engagement and monthly attendance in treatment . RESULTS Participants perceived higher positive regard , underst 
    Output:
    
The literature overview presents perspectives and knowledge of how to develop positive psychiatry , how mental health services and their partner organizations may become more recovery oriented and help persons reach well-being and a better quality of life .