Results
(3.4)6 (3.5)Substance dependence, psychiatric, DSM-5
DISORDERS
A total of 394 participants were included in the analysis: 196 were assigned to the intervention group and 198 to the control group. Interviews at the 12-month follow-up were completed for 127 (65%) in the PW-PAD group (four participants withdrew) and 139 (70%) in the control group (including five withdrawals) (see details in Supplementary Figure S2). Baseline characteristics and primary clinical outcomes are reported in Socio-demographic and clinical characteristics of participants (CharacteristicsPW-PAD goup (Control group (Gender, Men127 (64.8)112 (56.6)Age mean (SD), y37.4 (11.7)41.0 (12.7)Median (IQR)36 (28–44)40 (31–49)Nationality, French184 (93.9)180 (91.8)Education, Less than high school (<bac)57 (29.2)75 (37.9)Completed or postsecondary school138 (70.8)123 (62.1)Marital status, Single132 (67.3)128 (64.6)Married/partnered38 (19.4)35 (17.7)Divorced/separated/widow26 (13.3)35 (17.7)Work activity, Yes33 (18.8)37 (19.9)EPICES score mean (SD)40.6 (19.9)42.8(20.9)Median (IQR)40.8 (24–57)44.6 (26–59)DSM-5 diagnosis, Bipolar I disorder66 (33.8)73 (36.9)Schizophrenia86 (44.1)92 (46.5)Schizoaffective disorders43 (22.1)33 (16.7)Alcohol dependence, Yes6 (3.4)6 (3.5)Substance dependence, Yes22 (12.6)24 (13.6)With at least one somatic comorbidity, Yes120 (61.2)137 (69.2)CGI score mean (SD)4.1 (1.2)4.3 (1.1)Median (IQR)4.0 (3–5)4.0 (4–5)Number of admissions in the previous year, mean (SD)1.5 (0.9)1.4 (0.8)1132 (67.3)148 (75.5)245 (23.0)37 (18.9)≥317 (8.7)11 (5.6)Clinical outcomesMCSI score, mean (SD)11.49 (11.91)13.87 (10.99)ES score, mean (SD)16.80 (26.32)10.20 (16.04)RAS score, mean (SD)72.60 (14.13)65.55 (13.92)PW-PAD: peer worker–facilitated psychiatric advance directive; SD: standard deviation; IQR: interquartile range; DSM-5: Diagnostic and Statistical Manual of Mental Disorders, fifth edition; CGI: Clinical Global Impression scale.Recovery was assessed using the Recovery Assessment Scale (RAS) (Corrigan Mental health symptomatology was assessed using the self-report modified Colorado Symptom Index (MCSI; Conrad Empowerment was assessed using the Empowerment Scale (ES) (Rogers 