Citation

Jacobsen TB. Curr. Opin. Psychiatry 2012; 25(4): 307-310.

Affiliation

UEMS Section and European Board of Psychiatry, London, UK.

Copyright

(Copyright © 2012, Lippincott Williams and Wilkins)

DOI

10.1097/YCO.0b013e32835462e3

PMID

22569313

Abstract

PURPOSE OF REVIEW: Involuntary treatment is burdened by the lack of evidence. One of the challenges is the difference in practice across borders in Europe. While reviewing the current literature, a proposal of monitoring guidelines is discussed. RECENT FINDINGS: The field is characterized by a small number of dedicated researchers. A study of violence in first-episode psychosis shows that differences in criteria for involuntary admission lead to different prognosis for the patients. The most recent contributions from the cross-national EUNOMIA study point to great variation across countries, regarding frequencies of involuntary admission as well as outcome. The EUNOMIA study provides suggestions for good quality in involuntary admission. A Cochrane review has examined the evidence of involuntary community treatment compared with standard treatment. The effectiveness of involuntary community treatment is limited. The review concludes that the benefits for a small number of patients are outweighed by the high numbers needed to treat in terms of avoided re-admission. SUMMARY: Despite pioneering work, involuntary treatment is still caught up in tradition. There is a lack of standard and proof of effectiveness. A proposal of monitoring guidelines for involuntary measures is a first step to improve the situation.

Language: en