A Cochrane review [Abstract] 1 included 8 studies with a total of 1144 subjects. The majority of participants were psychotic (most suffering from schizophrenia), but there was a substantial representation of other diagnoses such as depression and severe neuroses. With the exception of mental state, it was not possible to pool data for the outcomes. Crisis intervention may reduce repeat admissions to hospital at 6 months (RR 0.75, CI 0.50 to 1.13; 1 RCT, n = 369), but does appear to reduce family burden (at 6 months: RR 0.34, CI 0.20 to 0.59, 1 RCT, n = 120), improve mental state (Brief Psychiatric Rating Scale (BPRS) at 3 months: MD -4.03, CI -8.18 to 0.12; 2 RCTs, n = 248), and improve global state (Global Assessment Scale (GAS) 20 months; MD 5.70, -0.26 to 11.66; 1 RCT, n = 142). Participants in the crisis-intervention group were more satisfied with their care 20 months after crisis (Client Satisfaction Questionnaire (CSQ-8): MD 5.40, CI 3.91 to 6.89; 1 RCT, n = 137). However, quality of life scores at 6 months were similar between treatment groups (Manchester Short Assessment of quality of life (MANSA); MD -1.50, CI -5.15 to 2.15;1 RCT, n = 226). Favourable results for crisis intervention were also found for leaving the study early and family satisfaction. No differences in death rates were found.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment, high drop-out rate) and imprecise results (few trials in each comparison).
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