SynthesisCanadian journal of psychiatry. Revue canadienne de psychiatrie2014
An updated meta-analysis of randomized controlled evidence for the effectiveness of community treatment orders.
Synthesis in Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The benefits and harms of community treatment orders for people diagnosed with psychiatric illnesses: A rapid umbrella review of systematic reviews and meta-analyses.The Australian and New Zealand journal of psychiatry · 2024Pooled it
- Compulsory community and involuntary outpatient treatment for people with severe mental disorders.The Cochrane database of systematic reviews · 2017Pooled it
- Understanding compulsory community treatment across Australian jurisdictions: insights from three different data sources.BJPsych open · 2026Article
- Community Treatment Orders in Australia in the Context of International Literature: A Narrative Review of Consumers, Families and Health Professionals' Perspectives.International journal of mental health nursing · 2025Review
- Compulsory treatment at home: an interview study exploring the experiences of an early group of patients, relatives and mental-health workers.BMC health services research · 2024Article
- Protecting Health and Safety with Needed-Treatment: the Effectiveness of Outpatient Commitment.The Psychiatric quarterly · 2022Review
- Hospital Utilization Outcomes Following Assignment to Outpatient Commitment.Administration and policy in mental health · 2021Review
- Community-Based Mental Health Care in Britain.Consortium psychiatricum · 2020Review
- Observational
- Compulsory treatment in patients' homes in the Netherlands: what do mental health professionals think of this?BMC psychiatry · 2020Article
- Out-patient commitment order use in Norway: incidence and prevalence rates, duration and use of mental health services from the Norwegian Outpatient Commitment Study.BJPsych open · 2019Article
- Patients on outpatient commitment orders in Northern Norway.BMC psychiatry · 2017Article
- What does being on a community treatment orders entail? A 3-year follow-up of the OCTET CTO cohort.Social psychiatry and psychiatric epidemiology · 2017Observational
- Care planning for consumers on community treatment orders: an integrative literature review.BMC psychiatry · 2016Review
- Recall of patients on community treatment orders over three years in the OCTET CTO cohort.BMC psychiatry · 2016Observational
- Little evidence for community treatment orders - a battle fought with heavy weapons.BJPsych bulletin · 2016Article
- Doubts About the Clinical Effectiveness of Community Treatment Orders.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2016Article
- Effectiveness of Community Treatment Orders: The International Evidence.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2016Review
- Residence Conditions on Community Treatment Orders.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2015Article
- Increased influence and collaboration: a qualitative study of patients' experiences of community treatment orders within an assertive community treatment setting.BMC health services research · 2015Article
Corrections and comments
- Erratum issuedErratum.2017
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesIt is unclear whether community treatment orders (CTOs) for people with severe mental illnesses can reduce health service use, or improve clinical and social outcomes. Randomized controlled trials of CTOs are rare because of ethical and logistical concerns. This meta-analysis updates available evidence.
methodA systematic literature search was performed of the Cochrane Schizophrenia Group Register, Science Citation Index, PubMed, MEDLINE, and Embase to November 2013. Inclusion criteria were studies comparing CTOs with standard care including those where control subjects received voluntary care, for most of the trial.
resultsThree studies provided 749 subjects for the meta-analysis. Two compared compulsory treatment with entirely voluntary care, while the third had control subjects receiving voluntary treatment for the bulk of the time. Compared with control subjects, CTOs did not reduce readmissions (risk ratio 0.98, 95% CI 0.82 to 1.16) or bed days (mean difference [MD] -16.36; 95% CI -40.8 to 8.05) in the subsequent 12 months (n = 749). Moreover, there were no significant differences in psychiatric symptoms (standardized MD -0.03; 95% CI -0.25 to 0.19; n = 331) or the Global Assessment of Functioning (MD -1.36; 95% CI -4.07 to 1.35; n = 335). Only including the 2 studies that compared compulsory treatment with entirely voluntary care made no difference to the results.
conclusionsCTOs may not lead to significant differences in readmission, social functioning, or symptomatology, compared with standard care. Their use should be kept under review.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.