title: Effectiveness of community treatment orders for treatment of schizophrenia with oral or depot antipsychotic medication: clinical outcomes.
abstract: OBJECTIVE
  This study examined the effectiveness of community treatment orders (CTOs) used in the treatment of patients with schizophrenia. The hypotheses were that CTOs enhance outcome for patients whose mental health would otherwise be compromised by poor adherence with treatment and that CTOs would enable this when either oral or depot antipsychotic medication was prescribed.
  
  
  METHODS
  This was a naturalistic study using a retrospective mirror-image design. The sample consisted of patients with schizophrenia (n = 94) who were treated on a CTO between November 1996 and October 1999. Two subgroups were defined: patients treated with oral antipsychotic medication (n = 31), and patients treated with depot medication (n = 63). Data were gathered via file review using a questionnaire.
  
  
  RESULTS
  For the whole sample and both subgroups the findings included significant increased number of service contacts, decreased number of admissions and decreased length of inpatient stay. For the total sample numbers of crisis team referrals and other episodes of relapse were significantly decreased. For the subgroup on depot medication there was a non-significant trend towards fewer crisis team referrals and a significant decrease in other episodes of relapse. There were no significant differences for the oral subgroup in crisis team referrals or other episodes of relapse.
  
  
  CONCLUSIONS
  This study provides further evidence that CTOs may be effective in improving the outcome for selected persons with schizophrenia and some evidence that they may enhance the outcome for selected patients with schizophrenia on oral antipsychotic medication.
authors.affiliation: North-west Area Mental Health Services, Coburg, Victoria, Australia. david.muirhead@mh.org.au
authors.forename: David
authors.initials: D
authors.lastname: Muirhead
authors.forename: Carol
authors.initials: C
authors.lastname: Harvey
authors.forename: Graham
authors.initials: G
authors.lastname: Ingram
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D003156:Community Mental Health Services / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*; D003692:Delayed-Action Preparations / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012017:Referral and Consultation; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy; D013383:Suburban Population; D016896:Treatment Outcome; D014505:Urban Population; D014739:Victoria
chemical_list: D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations