***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: CONTEXT Despite the availability of efficacious treatments , the long-term course of bipolar disorder is often unfavorable . OBJECTIVE To test the effectiveness of a multicomponent intervention program to improve the quality of care and long-term outcomes for persons with bipolar disorder . DESIGN R and omized controlled trial with allocation concealment and blinded outcome assessment . SETTING Mental health clinics of a group-model prepaid health plan . PATIENTS Of 785 patients in treatment for bipolar disorder who were invited to participate , 509 attended an evaluation appointment , 450 were found eligible to participate , and 441 enrolled in the trial . INTERVENTIONS Participants were r and omly assigned to a multicomponent intervention program or to continued care as usual . Three nurse care managers provided a 2-year systematic intervention program , including the following : a structured group psychoeducational program , monthly telephone monitoring of mood symptoms and medication adherence , feedback to treating mental health providers , facilitation of appropriate follow-up care , and as-needed outreach and crisis intervention . MAIN OUTCOME MEASURES In-person blinded research interviews every 3 months assessed mood symptoms using the Longitudinal Interval Follow-up Examination . Health plan administrative records were used to assess the use and cost of mental health services . RESULTS Intent-to-treat analyses demonstrated that the intervention significantly reduced the mean level of mania symptoms ( z = 2.09 , P = .04 ) and the time with significant mania symptoms ( 19.2 vs 24.7 weeks ; F(1 ) = 6.0 , P = .01 ) . There was no significant intervention effect on mean level of depressive symptoms ( z = 0.19 , P = .85 ) or time with significant depressive symptoms ( 47.6 vs 50.7 weeks ; F(1 ) = 0.56 , P = .45 ) . Benefits of the intervention were found only in a subgroup of 343 persons with clinical ly significant mood symptoms  at the baseline assessment . The incremental cost ( adjusted ) of the intervention was 1251 dollars ( 95 % confidence interval , 55 - 2446 dollars ) , including approximately 800 dollars for the intervention program services and an approximate 500 dollars increase in the costs of other mental health services . CONCLUSIONS Population -based systematic care programs can significantly reduce the frequency and severity of mania in bipolar disorder , and cost increases are modest considering the clinical gains . The incorporation of more specific cognitive and behavioral content or more effective medication regimens may be necessary to significantly reduce the symptoms of depression The study objective was to evaluate the feasibility of a telephone delivered intervention consisting of motivational interviewing and cognitive behavioural strategies aim ed at improving diet and physical activity in people diagnosed with psychotic disorders . Twenty participants diagnosed with a non-acute psychotic disorder were recruited . The intervention consisted of eight telephone delivered sessions targeting fruit and vegetable ( F&V ) consumption and leisure screen time , as well as smoking and alcohol use ( as appropriate ) . F&V frequency and variety , and overall diet quality ( measured by the Australian Recommended Food Score , ARFS ) , leisure screen time , overall sitting and walking time , smoking , alcohol consumption , mood , quality of life , and global functioning were examined before and 4-weeks post-treatment . Nineteen participants ( 95 % ) completed all intervention sessions , and 17 ( 85 % ) completed follow-up assessment s. Significant increases from baseline to post-treatment were seen in ARFS fruit , vegetable and overall diet quality scores , quality of life and global functioning . Significant reductions in leisure screen time and overall sitting time were also seen . Results indicated that a telephone delivered intervention targeting key cardiovascular disease risk behaviours appears to be feasible and relatively effective in the short-term for people diagnosed with psychosis . A r and omized controlled trial is warranted to replicate and extend these findings BACKGROUND A relapse prevention program called the Information Technology Aided Relapse Prevention Programme in Schizophrenia ( ITAREPS ) has been developed and is reported to be highly effective . However the effectiveness was influenced by user adherence to the protocol of the program , the exact effectiveness and the role of the ITAREPS have been partially uncertain . OBJECTIVE The purpose of this study is to evaluate the effectiveness of the ITAREPS excluding the effect of user adherence to the protocol of the program . METHOD We attempted to perform a r and omized controlled trial by the devised method with visiting nurse service . Out patients with schizophrenia were r and omized to the ITAREPS ( n=22 ) or control group ( n=23 ) and were observed for 12 months . RESULTS The risk of rehospitalization was reduced in the ITAREPS group ( 2 [ 9.1 % ] ) compared with the control group ( 8 [ 34.8 % ] ) ( hazard ratio=0.21 , 95 % CI 0.04 - 0.99 , p=0.049 ; number needed to treat (NNT)=4 , 95 % CI 2.1 - 35.5 ) . The mean number of inpatient days was significantly lower in the ITAREPS group ( 18.5 days ) compared with the control group ( 88.8 days ) ( p=0.036 ) . The ratio of the number of rehospitalizations to that of relapses was significantly lower ( p=0.035 ) and the mean change in total BPRS scores at relapse from baseline was significantly less in the ITAREPS group ( p=0.019 ) . CONCLUSIONS The relapse prevention effectiveness of the ITAREPS was high , and we confirmed that the ITAREPS , i.e. , detecting signs of relapse and increasing medication during the warning state , is an effective intervention during the early stages of relapse BACKGROUND Psychosocial interventions have the potential to enhance relapse prevention in bipolar disorder . AIMS To evaluate a manualised group-based intervention for people with bipolar disorder in a naturalistic setting . METHOD Eighty-four participants were r and omised to receive the group-based intervention ( a 12-week programme plus three booster sessions ) or treatment as usual , and followed up with monthly telephone interviews ( for 9 months post-intervention ) and face-to-face interviews ( at baseline , 3 months and 12 months ) . RESULTS Participants who received the group-based intervention were significantly less likely to have a relapse of any type and spent less time unwell . There was a reduced rate of relapse in the treatment group for pooled relapses of any type ( hazard ratio 0.43 , 95 % CI 0.20 - 0.95 ; t(343 ) = -2.09 , P = 0.04 ) . CONCLUSIONS This study suggests that the group-based intervention reduces relapse risk in bipolar disorder A true experimental , posttest only , control group design was used to pilot test the effectiveness of a telephone nursing intervention in increasing community survival , and decreasing the number and length of rehospitalizations for persons with schizophrenia . The vulnerability model was used as a framework for the study . The intervention was hypothesized to function as a moderating factor to reduce the effects of stress on vulnerable persons with schizophrenia . Experimental subjects received telephone nursing intervention weekly for 3 months ;  control subjects received informational calls at weeks 6 and 12 .  Readmission rates were 13 % ( n = 2 ) for experimental subjects and 23 % ( n = 5 ) for controls . Compared with controls , experimental subjects experienced a 4 % increase in community survival and a 27 % reduction in length of stay if readmission occurred . These preliminary data suggest that telephone intervention can increase community survival in persons with schizophrenia . Future studies should focus on increasing sample size and refining the intervention INTRODUCTION Bipolar disorder is one of ten most debilitating diseases in the world , leading to a lessened quality of life amongst its sufferers . This r and omised control trial demonstrates the effectiveness of psycho-education intervention along with a patient support system in the management of this disorder . METHODOLOGY In this trial , 108 patients , divided equally into two groups , were r and omly assigned to receive either pharmacotherapy alone ( control group ) or psycho-education along with pharmacotherapy treatment ( intervention group ) for a two year period . Each individual patient in the " intervention " group received eight , fifty-minute sessions of psychological education , followed by monthly telephone follow-up care and psychological support in the subsequent 18 months . Each group was evaluated , once every 6 months for a period of 18 months , in the areas of " quality of life " , " symptoms of relapse " , " pharmacotherapy compliance " and " number of hospital admission for recurrence of bipolar disorder " . RESULT The result of this study indicates that patients in the " intervention " group had a statistically significant enhancement in medication compliance ( P = 0.008 ) . Regarding every aspect of life quality , this group was at a better position than the " control " group ( P = 0.000 ) . As to relapse and hospital admission , the " intervention " group reported much lower cases compared with the " control " group at a significance level of P = 0.000 . CONCLUSION AND DISCUSSION This research has demonstrated that in the psycho-education intervention group , there was a more significant improvement in all areas of quality of life , number of relapses , and hospitalization due to recurrence of bipolar disorder and medication compliance than it was evident in the control groups Abstract Objective . Adherence to prescribed antipsychotic medication is a major factor in achieving optimal long-term clinical outcomes . The aim of this study was to evaluate the impact of a telephone-based strategy provided by a nurse on adherence to antipsychotic treatment among patients with schizophrenia . Methods . A total of 928 clinical ly stable out patients with schizophrenia were r and omized to receive a monthly telephone call by a nurse or routine clinical care . Telephone calls were performed at weeks 4 , 8 , and 12 , consisting of a st and ardized interview to detect and assess therapeutic adherence and subjective attitude towards medication . Patients were followed for 4 months . A cut-point of ≥ 60 % of prescribed dose was used to classify patients as being adherent . Results . At week 16 , a significantly higher percentage of patients who received a telephone-based follow-up ( 96.7 % , n = 410 ) were classified as adherent compared to the control group ( 91.2 % , n = 402 ) ( P = 0.0007 ) . Patients in the intervention group were significantly more likely to be adherent than control group ( adjusted OR = 3.3 95 % CI 1.6–6.6 , P = 0.0001 ) . Conclusions . Telephone-based nursing strategy  showed a significant improvement in adherence to antipsychotic drugs . Further studies are necessary to confirm if this kind of intervention could be a complementary strategy to optimize adherence in patients with schizophrenia Abstract Background : The National Institute for Clinical Excellence ( NICE ) guidelines recommend that individual cognitive-behaviour therapy ( CBT ) is offered to all people with a diagnosis of schizophrenia . In addition , the guidelines recommend that family intervention ( FI ) should be offered to all families of people with schizophrenia who are in close contact with the service user . However , implementation into routine services is poor . Aims : To survey mental health services to investigate how many people with a diagnosis of schizophrenia and their families are offered and receive CBT or FI . Methods : A comprehensive audit of a r and om sample of 187 service users receiving care from one , large mental health care trust in North West Engl and was conducted over a 12-month period . Results : The audit recorded that only 13 ( 6.9 % ) of services users were offered and 10 ( 5.3 % ) received individual CBT , while 3 ( 1.6 % ) services users were offered and 2 ( 1.1 % ) received FIs within the 12-month audit period . Conclusions : Implementation of CBT and FI is poor , particularly for FI . Reasons for poor implementation and service implication s are discussed OBJECTIVE This pilot study compared Life Goals Collaborative Care ( LGCC ) with enhanced treatment as usual in reducing cardiometabolic risk factors and improving outcomes for persons with bipolar disorder . METHODS Participants were r and omly assigned to LGCC ( N=34 ) or enhanced treatment as usual ( N=34 ) .  LGCC included four weekly self-management sessions and monthly telephone contacts for six months thereafter . Enhanced treatment as usual included wellness mailings . Outcomes were blood pressure , body mass index ( BMI ) , quality of life , functioning , and symptoms . RESULTS Compared with enhanced treatment as usual , LGCC was not associated with reductions in cardiometabolic risk factors in 12-month repeated- measures analyses . Among patients with a BMI of ≥30 or systolic blood pressure of ≥140 , LGCC was associated with improvements in functioning ( beta=-2.2 and beta=-3.8 , respectively , p=.04 ) and reduced depressive symptoms ( beta=-2.0 and -3.5 , respectively , p=.04 ) . CONCLUSIONS Further research is needed to determine whether LGCC improves outcomes for patients with elevated cardiometabolic risk INTRODUCTION People with severe mental disorders typically experience a range of health problems ; consequently , interventions addressing multiple health behaviors may provide an efficient way to tackle this major public health issue . This two-arm r and omized controlled trial among people with psychotic disorders examined the efficacy of nicotine replacement therapy ( NRT ) plus either a face-to-face or pre 
    Output:
    
Although most interventions combined telephone and face-to-face delivery , there was evidence to support the benefit of entirely telephone-delivered interventions .
Telephone interventions represent a potentially feasible and effective option for improving key health priorities among people with psychotic disorders .