Court-mandated outpatient psychiatric care for a pregnant woman with psychosis: a unique bridge to alliance.

We describe the case of a young pregnant woman with refractory schizoaffective disorder and how we reached a decision to apply for court-mandated outpatient psychiatric treatment (Assisted Outpatient Treatment or AOT). The patient was stable when we made this application as a preventive measure, given her serious prior episodes of illness. While there has been court-mandated outpatient obstetrical treatment, as far as we know this is the first report of mandated outpatient psychiatric treatment in connection with pregnancy. The ultimate benefit of this AOT application was the development of a therapeutic alliance and improved voluntary adherence to treatment, and a safe outcome to the pregnancy.