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Involuntary out-patient commitment and reduction of violent behaviour in persons with severe mental illness.

Publication ,  Journal Article
Swanson, JW; Swartz, MS; Borum, R; Hiday, VA; Wagner, HR; Burns, BJ
Published in: Br J Psychiatry
April 2000

BACKGROUND: Violent behaviour among persons with severe mental illness (SMI) causes public concern and is associated with illness relapse, hospital recidivism and poor outcomes in community-based treatment. AIMS: To test whether involuntary out-patient commitment (OPC) may help to reduce the incidence of violence among persons with SMI. METHOD: One-year randomised trial of the effectiveness of OPC in 262 subjects with psychotic or major mood disorders and a history of hospital recidivism. Involuntarily hospitalised subjects awaiting OPC were randomly assigned to release or court-ordered treatment after discharge. Those with a recent history of serious assault remained under OPC until expiry of the court order (up to 90 days); then OPC orders were renewed at clinical/court discretion. Control subjects had no OPC. Four-monthly follow-up interviews with subject, case manager and collateral informant took place and service records were collected. RESULTS: A significantly lower incidence of violent behaviour occurred in subjects with > or = 6 months' OPC. Lowest risk of violence was associated with extended OPC combined with regular out-patient services, adherence to prescribed medications and no substance misuse. CONCLUSIONS: OPC may significantly reduce risk of violent behaviour in persons with SMI, in part by improving adherence to medications while diminishing substance misuse.

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Published In

Br J Psychiatry

DOI

ISSN

0007-1250

Publication Date

April 2000

Volume

176

Start / End Page

324 / 331

Location

England

Related Subject Headings

  • Violence
  • Substance-Related Disorders
  • Socioeconomic Factors
  • Psychiatry
  • Patient Compliance
  • Multivariate Analysis
  • Mood Disorders
  • Middle Aged
  • Mental Disorders
  • Male
 

Citation

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Chicago
ICMJE
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Swanson, J. W., Swartz, M. S., Borum, R., Hiday, V. A., Wagner, H. R., & Burns, B. J. (2000). Involuntary out-patient commitment and reduction of violent behaviour in persons with severe mental illness. Br J Psychiatry, 176, 324–331. https://doi.org/10.1192/bjp.176.4.324
Swanson, J. W., M. S. Swartz, R. Borum, V. A. Hiday, H. R. Wagner, and B. J. Burns. “Involuntary out-patient commitment and reduction of violent behaviour in persons with severe mental illness.Br J Psychiatry 176 (April 2000): 324–31. https://doi.org/10.1192/bjp.176.4.324.
Swanson JW, Swartz MS, Borum R, Hiday VA, Wagner HR, Burns BJ. Involuntary out-patient commitment and reduction of violent behaviour in persons with severe mental illness. Br J Psychiatry. 2000 Apr;176:324–31.
Swanson, J. W., et al. “Involuntary out-patient commitment and reduction of violent behaviour in persons with severe mental illness.Br J Psychiatry, vol. 176, Apr. 2000, pp. 324–31. Pubmed, doi:10.1192/bjp.176.4.324.
Swanson JW, Swartz MS, Borum R, Hiday VA, Wagner HR, Burns BJ. Involuntary out-patient commitment and reduction of violent behaviour in persons with severe mental illness. Br J Psychiatry. 2000 Apr;176:324–331.
Journal cover image

Published In

Br J Psychiatry

DOI

ISSN

0007-1250

Publication Date

April 2000

Volume

176

Start / End Page

324 / 331

Location

England

Related Subject Headings

  • Violence
  • Substance-Related Disorders
  • Socioeconomic Factors
  • Psychiatry
  • Patient Compliance
  • Multivariate Analysis
  • Mood Disorders
  • Middle Aged
  • Mental Disorders
  • Male