Out-patient commitment order use in Norway: incidence and prevalence rates, duration and use of mental health services from the Norwegian Outpatient Commitment Study.

Autor:	Riley H; Research Director, Division of Mental Health and Substance Abuse, University Hospital of North Norway, Norway., Sharashova E; Postdoctoral Fellow, Department of Community Medicine, UiT The Arctic University of Norway, Norway., Rugkåsa J; Professor, Health Services Research Unit, Akershus University Hospital; and Centre for Care Research, University of South-Eastern Norway, Norway., Nyttingnes O; Postdoctoral Fellow, Health Services Research Unit, Akershus University Hospital; and R&D Department, Division of Mental Health Services, Akershus University Hospital, Norway., Christensen TB; Clinical Psychiatrist, Department of Mental Health, Sørlandet Hospital, Norway., Austegard AA; Senior Advisor, Division of Psychiatry, Haukeland University Hospital, Norway., Løvsletten M; Doctoral Research Fellow, Division of Mental Health Care, Innlandet Hospital Trust, Norway., Lau B; Professor, Lovisenberg Diaconal Hospital, Norway., Høyer G; Professor Emeritus, Division of Mental Health and Substance Abuse, University Hospital of North Norway; and Department of Community Medicine, UiT The Arctic University of Norway, Norway.
Jazyk:	angličtina
Zdroj:	BJPsych open [BJPsych Open] 2019 Sep 02; Vol. 5 (5), pp. e75. Date of Electronic Publication: 2019 Sep 02.
DOI:	10.1192/bjo.2019.60
Abstrakt:	Background: Norway authorised out-patient commitment in 1961, but there is a lack of representative and complete data on the use of out-patient commitment orders. Aims: To establish the incidence and prevalence rates on the use of out-patient commitment in Norway, and how these vary across service areas. Further, to study variations in out-patient commitment across service areas, and use of in-patient services before and after implementation of out-patient commitment orders. Finally, to identify determinants for the duration of out-patient commitment orders and time to readmission. Method: Retrospective case register study based on medical files of all patients with an out-patient commitment order in 2008-2012 in six catchment areas in Norway, covering one-third of the Norwegian population aged 18 years or more. For a subsample of patients, we recorded use of in-patient care 3 years before and after their first-ever out-patient commitment. Results: Annual incidence varied between 20.7 and 28.4, and prevalence between 36.5 and 48.9, per 100 000 population aged 18 years or above. Rates differed significantly between catchment areas. Mean out-patient commitment duration was 727 days (s.d. = 889). Use of in-patient care decreased significantly in the 3 years after out-patient commitment compared with the 3 years before. Use of antipsychotic medication through the whole out-patient commitment period and fewer in-patient episodes in the 3 years before out-patient commitment predicted longer time to readmission. Conclusions: Mechanisms behind the pronounced variations in use of out-patient commitment between sites call for further studies. Use of in-patient care was significantly reduced in the 3 years after a first-ever out-patient commitment order was made. Declaration of Interest: None.
Databáze:	MEDLINE
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