Effect of comprehensive community intervention on recurrence rate of severe mental patients in China:a meta-analysis

Objective To evaluate the effect of comprehensive community management on recurrence rate of severe mental patients.Methods A comprehensive search was performed through databases including PubMed, Elsevier Science Direct, Web of Knowledge, China Knowledge Infrastructure(CNKI), China Online Journals, Chinese Science and Technology Periodical Database, and Chinese Biomedical Database using the key words including severe mental disease, severe psychosis, schizophrenia, community, and China to identify completely randomized controlled trials and non-randomized concurrent controlled trials of community-based rehabilitation intervention on severe mental patients from April 2004 through April 2015.Stata 12 software was adopted for meta-analysis.Results Ten articles(nine published in Chinese and one in English) were included, with totally 854 intervened cases and 832 controls.The meta-analysis results indicated that comprehensive community intervention effectively prevented severe mental patients from recurrence; the risk of the disease recurrence for intervention group was 0.322 compared to the control group during the follow-up period(odds ratio OR=0.322, 95% confidence interval 95% CI:0.241, 0.430).The funnel plot showed no significant asymmetry, with the P-values of 0.283 and 0.151 for Begger's and Egger's test, and no significant publication bias was observed for the included articles; meanwhile, sensitivity analysis indicated that the results of the analysis were relatively stable.Conclusion Comprehensive community intervention has significant positive effect on reducing recurrence rate among severe mental patients and is helpful to promote the accessibility of mental health service and reduce social and family burden of severe mental disease.