Lehman 1993.
| Methods | Allocation: randomised. Design: single‐centre. Duration: 12 months. Setting: community. Location: Baltimore, Md, USA. | |
| Participants | Diagnosis: 67% DSM‐III‐R schizophrenia /schizoaffective disorder with co‐occurring substance disorder. N = 29.* Age: 18‐40 years, mean ˜ 31 years. Sex: 22 M, 7 F. Ethnicity: 70% Afro‐American. Inclusion criteria: current substance abuse or dependence disorder. | |
| Interventions | 1. Psychosocial intervention: routine care plus intensive case management: educational group sessions on substance abuse/mental illness (5 hours per week), experiential "rap" session, on‐site self‐help group, off‐site self‐help group (AA/NA), social activities. 1:15 staff‐patient ratio. N = 14. 2. Standard care: CMHC‐based, psychosocial rehabilitation services, routine outpatient services, supported housing if needed, no organised substance abuse treatment. 1:25 staff‐patient ratio. N = 15. | |
| Outcomes | Leaving the study early: lost to evaluation. Unable to use Lost to treatment: data reporting unclear. Substance use: ASI‐alcohol, ASI‐drug (data skewed). Mental state: ASI‐psychiatric (data skewed). Relapse: days in hospital (data skewed). Other: QOLI (Life satisfaction) (all data skewed). |
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| Notes | ITT analysis. * Data reported in this review are based only on those who had current (past 30 days) substance use disorders (29 out of 54). |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Randomised using the urn method. No further details. |
| Allocation concealment (selection bias) | Unclear risk | Unclear, no details provided. |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | Clinician‐/participant‐mediated and participants and personnel not blinded. It is not possible to blind a psychosocial intervention. |
| Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Blindness not stated. |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Lost to follow‐up: 0% (0/29) 1 year. No missing outcome data. |
| Selective reporting (reporting bias) | Unclear risk | Insufficient information to permit judgement of 'yes' or 'no' as no protocol was available. |
| Other bias | Low risk | No evidence other bias occurring. |