Department of Psychological Medicine, University of Otago, New Zealand Department of Psychological Medicine, Imperial College, UK
Whatever It Takes (WIT), Napier, New Zealand.
Int J Soc Psychiatry. 2014 Aug;60(5):474-81. doi: 10.1177/0020764013498870. Epub 2013 Aug 27.
There is little objective evidence to support the use of community treatment orders (CTOs) from randomized controlled trials. Qualitative research indicates more negative than positive responses to the use of CTOs. Nonetheless, the use of CTOs is growing internationally. There is no research to identify for whom CTOs may be a positive experience.
To assess patients' perspectives of CTOs, assessing for correlates with clinical and demographic variables.
Patients currently or previously subject to a CTO were assessed quantitatively to identify their experience. Demographic data, the experience of coercion, views of detention, satisfaction with care, social functioning and psychopathology were correlated using SPSS.
Fifty-three per cent of patients felt that they were, on balance, better off when treated informally in the community. Patients described greater coercion and less satisfaction with care when subject to a CTO. These factors, and being in employment, identified patients whom felt harmed by CTOs 61% of the time.
This paper highlights that more than half of patients under a CTO consider it negatively. This group is identified by patients who work, experience coercion and are unsatisfied with care. This has implications for the application of CTOs.
随机对照试验几乎没有客观证据支持使用社区治疗令（CTO）。定性研究表明，对 CTO 的使用反应更多是负面的而不是正面的。尽管如此，CTO 的使用在国际上仍在不断增加。目前还没有研究来确定 CTO 可能对哪些人是积极的体验。
评估患者对 CTO 的看法，评估与临床和人口统计学变量的相关性。
目前或以前接受 CTO 的患者接受了定量评估，以确定他们的体验。使用 SPSS 对人口统计学数据、强制体验、拘留看法、护理满意度、社会功能和精神病理学进行了相关性分析。
53%的患者认为，在社区中非正式治疗时，他们总体上情况更好。接受 CTO 治疗的患者描述了更多的强制和对护理的不满。这些因素，以及就业状况，确定了 61%的患者认为 CTO 对他们造成了伤害。
本文强调，超过一半的 CTO 患者认为其负面影响大于正面影响。这一群体是由工作的患者、经历强制和对护理不满的患者组成的。这对 CTO 的应用有影响。
