A literature review of the effectiveness of community treatment order with first episode psychosis population

Poster A63, Monday, October 8, 11:30 am - 1:00 pm, Essex Ballroom

Minh Thi Nguyen1,2, Amal Abdel-Baki1,2,3; 1Department of Psychiatry, University of Montreal, 2University of Montreal Hospital Center, 3University of Montreal Hospital and Research Center

Context: Community treatment order (CTO) effectiveness is still questioned and recent studies showed no significant patient benefit. First episode psychosis (FEP) patients are known to have poor adherence to treatment which has been associated with poor prognosis. CTO can be a tool to improve adherence, but it is also a coercive method. Therefore, we need clear evidence of CTO’s patient benefit. Objectives: To review the literature on the effectiveness of CTO and determine if these previously published studies can be generalised to FEP. Methods: Systematic literature review using PUBMED and PsycINFO electronic databases as well as grey literature and manual research. The criteria for studies selection were: adult population, severe mental illness and measures of CTO effectiveness. The different legislations of the jurisdictions where the studies were conducted were explored. Results: Since CTO in the different jurisdictions are very different in terms of treatment definition and content, duration, as well as means to apply the CTO, because of some methodological flaws and different patient’s characteristics, previous results on CTO effectiveness are for most, not generalizable to the FEP population. An Australian study on FEP reports that CTO are frequently used (19,2%) and that FEP patients under CTO share similar characteristics with patients with severe and persistent mental illness under CTO. Conclusions: Although previous studies raise relevant questions about CTO’s effectiveness, CTO are very dependent of the local jurisdiction. Moreover only one Australian study looked at the use of CTO for FEP, therefore further studies should be conducted on this population.

Topic Area: First Episode Psychosis

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