Program for Assertive Community Treatment (PACT): As an extension of studies into the effect of Assertive Community Treatment Programs on client outcomes, family burdens, service mix, and costs, we are extending our work to a meta-analysis of outcomes using data from five just-completed PACT studies at geographically diverse sites throughout the U.S. As existing research has suggested that a major point of impact of PACTs is on institutionalization, we will initially focus our analyses on psychiatric hospital admissions and hospital days. Interest is in (1) determining if PACTs effectively reduce admissions and days relative to state-of-the-art community mental health programs and (2) if so, are reductions associated with patient characteristics including age, race, sex, and diagnosis.
Outpatient Commitment Programs (OPC): Data collection and management continue on a study of the effects of outpatient commitment on client outcomes, compliance, and family burden among the severely and persistently mentally ill (SPMI). Substantial recruitment has already occurred allowing the possibility of panel analyses of the baseline profile of the sample. Questions of interest include sex and race differences in quality-of-life indices, social interactions, social networks, and diagnosis. We are also exploring the possibility of combining these data with a similar study sampel recruited for a study of PACT programs in Charleston, S.C. The two studies share considerable common information; combined analyses would expand the base of inference and provide a marked increase in power necessary for assessment of often highly variable psychosocial outcomes.
Somatic Manifestations of Depression: We are continuing to investigate the association between CES-D scores and mortality. Using a geriatric sample, we have demonstrated a positive association between CES-D scores and mortality over a five year interval. Current efforts are directed at refining the association between CES-D scores and the appearance of various disease states over the same interval. We continue to hypothesize a relationship between depression and impaired immune function as operationalized in the disproportionate incidence of infectious diseases and neoplastic events.