New directions in research on involuntary outpatient commitment.
New directions in research on involuntary outpatient commitment.
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非自愿门诊承诺研究的新方向。
DOI：
10.1176/ps.46.4.381
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Wagner,HR
中科院分区：
文献类型：
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作者：
Swartz,MS;Burns,BJ;Hiday,VA;George,LK;Swanson,J;Wagner,HR
目的非自愿门诊承诺已被用作改善社区项目中严重和持续性精神疾病患者终身教职的一种方法。本文回顾了非自愿门诊承诺的研究文献，并提出了未来研究的问题和方法。方法通过检索MEDLINE和跟踪相关文献中引用的文献，对非自愿门诊承诺的研究进行综述，重点关注患者特征、诊断、治疗和结果测量。结果非自愿门诊承诺在再住院率和住院时间方面似乎提供了有限但改善的结果。社区治疗的变异性使得解释其他类型的结果变得困难。很少有研究特别确定严重和持续性精神疾病患者的结果。结论没有研究考察当持续和积极地提供基本的社区服务时，门诊承诺对依从性和治疗的影响程度，也没有研究控制潜在的混杂因素，如治疗和非治疗效果，包括非正式强迫。一项非自愿门诊承诺的随机试验在评估这类干预措施的有效性方面应该是有用的。
ObjectiveInvoluntary outpatient commitment has been used as a method of improving tenure in community programs for individuals with severe and persistent mental illness. This paper reviews literature on research about involuntary outpatient commitment and suggests questions and methods for future research.MethodsLiterature describing research studies of involuntary outpatient commitment, located by searching MEDLINE and following up references cited in relevant articles, was reviewed with attention to patient characteristics and diagnostic, treatment, and outcomes measures.ResultsInvoluntary outpatient commitment appears to provide limited but improved outcomes in rates of rehospitalization and lengths of hospital stay. Variability in community treatment makes interpretation of other types of outcome difficult. Few studies specifically identify results among patients with severe and persistent mental illness.ConclusionsNo studies have examined the extent to which outpatient commitment affects compliance and treatment when essential community services such as case management are consistently and aggressively provided, nor have studies controlled for potentially confounding factors such as treatment and nontreatment effects, including informal coercion. A randomized trial of involuntary outpatient commitment should be useful in evaluating the effectiveness of this type of intervention.