Community treatment of psych patients tied to less mortality

Steve Kisely, M.D., Ph.D., from Dalhousie University in Halifax, Canada, and colleagues conducted a population-based survival analysis to examine whether community treatment could reduce all-cause mortality among patients with psychiatric disorders. The study involved 2,958 patients with community treatment orders and 2,958 matched controls, all of whom were patients in psychiatric services in Western Australia.

Cases and controls had an average age of 36.7 years, and 63.7 percent were male. The researchers found that, among participants, schizophrenia and other non-affective psychoses were the most common diagnoses (73.4 percent). During the study, a total of 492 patients (8.3 percent) died. Patients with community treatment orders had significantly lower all-cause mortality at one, two, and three years, compared with controls, with an adjusted hazard ratio of 0.62 at two-years. The greatest reduction in mortality came from physical illnesses, including cancer, cardiovascular disease, or diseases of the central nervous system, but the association disappeared when adjusting for increased outpatient and community contacts with psychiatric services.

"Community treatment orders might reduce mortality associated with preventable physical illness among patients with psychiatric disorders," the authors write. "Such a reduction may be partly explained by increased contact with health services in the community and better access to medically necessary treatments."

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Journal reference: Canadian Medical Association Journal

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