DeRidder Ritz, Molodynski Andrew, Manning Catherine, McCusker Pearse, Rugkåsa Jorun
Berkshire Healthcare NHS Foundation Trust, Reading, UK.
Oxford Health NHS Foundation Trust, Oxford, UK.
BJPsych Bull. 2016 Jun;40(3):119-23. doi: 10.1192/pb.bp.115.050773.
Aims and method Community treatment orders (CTOs) are increasingly embedded into UK practice and their use continues to rise. However, they remain highly controversial. We surveyed psychiatrists to establish their experiences and current opinions of using CTOs and to compare findings with our previous survey conducted in 2010. Results The opinions of psychiatrists in the UK have not changed since 2010 in spite of recent evidence questioning the effectiveness of CTOs. Clinical factors (the need for engagement and treatment adherence, and the achievement of adherence and improved insight) remain the most important considerations in initiating and discharging a CTO. Clinical implications Given the accumulating evidence from research and clinical practice that CTOs do not improve outcomes, it is concerning that psychiatrists' opinions have not altered in response, particularly given the implications for patient care.
目的与方法 社区治疗令(CTOs)在英国的实践中越来越根深蒂固,其使用也持续增加。然而,它们仍然极具争议性。我们对精神科医生进行了调查,以了解他们使用社区治疗令的经历和当前看法,并将调查结果与我们2010年进行的先前调查进行比较。结果 尽管最近有证据质疑社区治疗令的有效性,但自2010年以来,英国精神科医生的看法并未改变。临床因素(参与和治疗依从性的必要性,以及实现依从性和改善洞察力)仍然是启动和解除社区治疗令时最重要的考虑因素。临床意义 鉴于来自研究和临床实践的越来越多的证据表明社区治疗令并不能改善治疗结果,令人担忧的是,精神科医生的看法并未因此而改变,特别是考虑到这对患者护理的影响。