A description of the community treatment order use among first episode psychosis population

Poster A64, 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: Although early intervention for psychosis reduces duration of untreated psychosis and improves outcome, and despite high prevalence of poor adherence to treatment, studies on the use of community treatment orders (CTO) among first episode psychosis (FEP) as a mean to improve treatment adherence is sparse. Objectives: In the context of early intervention for psychosis services, to describe: 1) the frequency of CTO utilisation, 2) the timing (from admission) when a CTO is requested, 3) the reasons why CTOs are requested, 4) the evolution of CTO utilisation over 10 years. Methods : Descriptive prospective longitudinal 5 years study (from 2005 to 2016) in two urban EIS affiliated to the University of Montreal describing the use of CTO in a cohort of 568 patients. Results : CTOs are requested early in the follow-up in up to 20,8% of FEP, mainly during the first three years. The main reasons for requesting a CTO are to prevent: deterioration in mental status, decline in social functioning, harmful behaviours and homelessness. After an initial augmenting trend, there was a decline in CTO use from 2009, possibly because of earlier use of long acting injectable antipsychotic medication during the illness course, which could better prevent relapses or deterioration. Conclusions : CTOs could be a tool to improve adherence to treatment, which is crucial for relapse prevention in FEP. Since it is a coercive method that limits the person’s fundamental rights, more research is warranted on its impact on outcome and the characteristics of those requiring it.

Topic Area: First Episode Psychosis

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