Assertive community treatment in the Netherlands: a randomized controlled trial.
OBJECTIVE
Assertive community treatment is rapidly implemented by many European mental health services, but recently the evidence base has been questioned. Positive results of randomized trials in the USA were not replicated in the UK. The question is whether the UK findings are representative for other European countries with modern mental health services.


METHODS
Open randomized controlled trial of long-term severely mentally ill patients [Health of the Nation Outcome Scales (HoNOS) total score >or=15], assigned to assertive community treatment (n = 59) or to standard community mental health care (n = 59).


METHODS
sustained contact; housing stability and admission days. This trial is registered as an International Standard Randomized Clinical Trial, number ISRCTN 11281756.


RESULTS
Assertive community treatment was significantly better in sustaining contact with patients, but not in reducing admission days. No differences in housing stability, psychopathology, social functioning or quality of life were found.


CONCLUSIONS
The results are in agreement with UK studies. However, the sustained contact potential of assertive community treatment is important, as too many patients are lost in standard care.
Sytema
S
S
Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. s.sytema@med.umcg.nl
Wunderink
L
L
Bloemers
W
W
Roorda
L
L
Wiersma
D
D
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D003156:Community Mental Health Services; D003299:Cooperative Behavior; D003419:Crisis Intervention / Q000706:statistics & numerical data; D003702:Delusions / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team; D010359:Patient Readmission / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D012050:Rehabilitation, Vocational / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D014600:Utilization Review / Q000706:statistics & numerical data