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Sailing for rehabilitation of patients with severe mental disorders: results of a cross over randomized controlled trial.

Carta MG, Maggiani F, Pilutzu L, Moro MF, Mura G, Cadoni F, Sancassiani F, Vellante M, Machado S, Preti A - Clin Pract Epidemiol Ment Health (2014)

Bottom Line: Out of the 40 patients enrolled in the study, those exposed to rehabilitation with sailing during a series of guided and supervised sea expeditions near the beach of Cagliari (Sardinia), where the aim to explore the marine environment while sailing was emphasized, showed a statistically significant improvement of their clinical status (measured by BPRS) and, as well, of their general functioning (measured by HoNOS Scale) against the control group.The improvement was maintained at follow-up for some months only: after 12 months, the patients returned to their baseline values on the measures of psychopathology and showed a worsening trend of their quality of life.Sailing can represent a substitute of important experiences that the patients with severe mental disorders miss because of their illness.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health and Clinical and Molecular Medicine University of Cagliari and Centro di Psichiatria di Consulenza e Psicosomatica AUOC Cagliari, Cagliari, Italy.

ABSTRACT
This study set out to evaluate the effectiveness of a sailing and learning-to-sail rehabilitation protocol in a sample of patients diagnosed with severe mental disorders. The study was a randomized, crossover, waiting-list controlled trial, following recruitment in the Departments of Mental Health of South Sardinia. Participants were outpatients diagnosed with severe mental disorders, recruited through announcements to the directors of the Departments of Mental Health of South Sardinia. Out of the 40 patients enrolled in the study, those exposed to rehabilitation with sailing during a series of guided and supervised sea expeditions near the beach of Cagliari (Sardinia), where the aim to explore the marine environment while sailing was emphasized, showed a statistically significant improvement of their clinical status (measured by BPRS) and, as well, of their general functioning (measured by HoNOS Scale) against the control group. The improvement was maintained at follow-up for some months only: after 12 months, the patients returned to their baseline values on the measures of psychopathology and showed a worsening trend of their quality of life. Sailing can represent a substitute of important experiences that the patients with severe mental disorders miss because of their illness.

No MeSH data available.


Related in: MedlinePlus

Distribution of scores on the BPRS, HoNOS and GAF over time, by group.
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Figure 1: Distribution of scores on the BPRS, HoNOS and GAF over time, by group.

Mentions: No statistically significant differences have been found between the two groups regarding major socio-demographic variables and the clinical measures at baseline but age, with the patients in Group B being on average and marginally younger than those in Group A (Table 1). Long-term effects of the rehabilitation with sailing Group A recorded 2 dropouts, one in the second month and the other in the third. Group B had 5 dropouts, all occurring in the 13th month (one month after the start of the rehabilitation with sailing for this group). Dropouts did not differ from the patients who stayed in treatment by any of the measures at baseline (p > .05 in all comparisons). A repeated ANOVA measurement with a Greenhouse-Geisser correction determined that measures of psychopathology underwent statistically significant changes over time. Mean HoNOS and BPRS scores differed significantly statistically between time points, and the changes differed between groups (Table 2). Between-group differences over time were less evident on the GAF. As far as the measure of quality of life is concerned, differences between groups over time were evident for the physical and social areas, and less evident for the psychological and environmental areas (Table 2). Comparisons at the pre-defined time points showed that changes over time were congruent with an effect of the rehabilitation with sailing, with improvement on the HoNOS and the BPRS in the groups in coincidence with the expeditions in the open sea, and no changes when there were no expeditions (Fig. 1). Differences across the period of exposition to the rehabilitation with sailing were more evident in Group B as far as symptoms and social functioning were concerned, and in Group A concerning quality of life. 15 patients out of 18 (83%) in Group A showed RCI on the HoNOS, versus 3 out of 20 (15%) in Group B at the end of the first year (χ2 = 15.11, df = 1, p < .0001). The proportion reversed in the second year: 2 patients out of 18 (11%) vs 14 out of 15 (93%) in the second year (χ2 = 18.97, df = 1, p < .0001). Patients with RCI on the BPRS were 16 out of 18 (89%) in Group A and 2 out of 20 (10%) in Group B after the first year (χ2 = 20.59, df = 1, p < .0001); they were 2 out of 18 (11%) in Group A and 15 out of 15 (100%) in Group B at the end of the second year (χ2 = 22.44, df = 1, p < .0001). Concerning the GAF, RCI for improvement was observed in 13 out of 18 (72%) patients in Group A and in no Group B patient (χ2 = 18.86, df = 1, p < .0001) at the end of the first year; and in 6 out of 18 (33%) in Group A and in 15 out of 15 (100%) in Group B at the end of the second year (χ2 = 12.96, df = 1, p < .0001). The benefit of the rehabilitation with sailing did not persist at follow-up (see Fig. 1). In Group A, this was observed 6 months after the end of the rehabilitation with sailing through the scores on the HoNOS, the BPRS, and the GAF. The 6-month follow-up after termination of rehabilitation with sailing in Group B was not assessed because the study was not allocated funds to complete the second phase of the cross-over trial.


Sailing for rehabilitation of patients with severe mental disorders: results of a cross over randomized controlled trial.

Carta MG, Maggiani F, Pilutzu L, Moro MF, Mura G, Cadoni F, Sancassiani F, Vellante M, Machado S, Preti A - Clin Pract Epidemiol Ment Health (2014)

Distribution of scores on the BPRS, HoNOS and GAF over time, by group.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150377&req=5

Figure 1: Distribution of scores on the BPRS, HoNOS and GAF over time, by group.
Mentions: No statistically significant differences have been found between the two groups regarding major socio-demographic variables and the clinical measures at baseline but age, with the patients in Group B being on average and marginally younger than those in Group A (Table 1). Long-term effects of the rehabilitation with sailing Group A recorded 2 dropouts, one in the second month and the other in the third. Group B had 5 dropouts, all occurring in the 13th month (one month after the start of the rehabilitation with sailing for this group). Dropouts did not differ from the patients who stayed in treatment by any of the measures at baseline (p > .05 in all comparisons). A repeated ANOVA measurement with a Greenhouse-Geisser correction determined that measures of psychopathology underwent statistically significant changes over time. Mean HoNOS and BPRS scores differed significantly statistically between time points, and the changes differed between groups (Table 2). Between-group differences over time were less evident on the GAF. As far as the measure of quality of life is concerned, differences between groups over time were evident for the physical and social areas, and less evident for the psychological and environmental areas (Table 2). Comparisons at the pre-defined time points showed that changes over time were congruent with an effect of the rehabilitation with sailing, with improvement on the HoNOS and the BPRS in the groups in coincidence with the expeditions in the open sea, and no changes when there were no expeditions (Fig. 1). Differences across the period of exposition to the rehabilitation with sailing were more evident in Group B as far as symptoms and social functioning were concerned, and in Group A concerning quality of life. 15 patients out of 18 (83%) in Group A showed RCI on the HoNOS, versus 3 out of 20 (15%) in Group B at the end of the first year (χ2 = 15.11, df = 1, p < .0001). The proportion reversed in the second year: 2 patients out of 18 (11%) vs 14 out of 15 (93%) in the second year (χ2 = 18.97, df = 1, p < .0001). Patients with RCI on the BPRS were 16 out of 18 (89%) in Group A and 2 out of 20 (10%) in Group B after the first year (χ2 = 20.59, df = 1, p < .0001); they were 2 out of 18 (11%) in Group A and 15 out of 15 (100%) in Group B at the end of the second year (χ2 = 22.44, df = 1, p < .0001). Concerning the GAF, RCI for improvement was observed in 13 out of 18 (72%) patients in Group A and in no Group B patient (χ2 = 18.86, df = 1, p < .0001) at the end of the first year; and in 6 out of 18 (33%) in Group A and in 15 out of 15 (100%) in Group B at the end of the second year (χ2 = 12.96, df = 1, p < .0001). The benefit of the rehabilitation with sailing did not persist at follow-up (see Fig. 1). In Group A, this was observed 6 months after the end of the rehabilitation with sailing through the scores on the HoNOS, the BPRS, and the GAF. The 6-month follow-up after termination of rehabilitation with sailing in Group B was not assessed because the study was not allocated funds to complete the second phase of the cross-over trial.

Bottom Line: Out of the 40 patients enrolled in the study, those exposed to rehabilitation with sailing during a series of guided and supervised sea expeditions near the beach of Cagliari (Sardinia), where the aim to explore the marine environment while sailing was emphasized, showed a statistically significant improvement of their clinical status (measured by BPRS) and, as well, of their general functioning (measured by HoNOS Scale) against the control group.The improvement was maintained at follow-up for some months only: after 12 months, the patients returned to their baseline values on the measures of psychopathology and showed a worsening trend of their quality of life.Sailing can represent a substitute of important experiences that the patients with severe mental disorders miss because of their illness.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health and Clinical and Molecular Medicine University of Cagliari and Centro di Psichiatria di Consulenza e Psicosomatica AUOC Cagliari, Cagliari, Italy.

ABSTRACT
This study set out to evaluate the effectiveness of a sailing and learning-to-sail rehabilitation protocol in a sample of patients diagnosed with severe mental disorders. The study was a randomized, crossover, waiting-list controlled trial, following recruitment in the Departments of Mental Health of South Sardinia. Participants were outpatients diagnosed with severe mental disorders, recruited through announcements to the directors of the Departments of Mental Health of South Sardinia. Out of the 40 patients enrolled in the study, those exposed to rehabilitation with sailing during a series of guided and supervised sea expeditions near the beach of Cagliari (Sardinia), where the aim to explore the marine environment while sailing was emphasized, showed a statistically significant improvement of their clinical status (measured by BPRS) and, as well, of their general functioning (measured by HoNOS Scale) against the control group. The improvement was maintained at follow-up for some months only: after 12 months, the patients returned to their baseline values on the measures of psychopathology and showed a worsening trend of their quality of life. Sailing can represent a substitute of important experiences that the patients with severe mental disorders miss because of their illness.

No MeSH data available.


Related in: MedlinePlus