Out-patient commitment order use in Norway: incidence and prevalence rates, duration and use of mental health services from the Norwegian Outpatient Commitment Study
Open accessAbstract
Background: Norway authorised out-patient commitment in 1961, but there is a lack of representative and complete data on the use of out-patient commitment orders. Aims: To establish the incidence and prevalence rates on the use of out-patient commitment in Norway, and how these vary across service areas. Further, to study variations in out-patient commitment across service areas, and use of in-patient services before and after implementation of out-patient commitment orders. Finally, to identify determinants for the duration of out-patient commitment orders and time to readmission. Method: Retrospective case register study based on medical files of all patients with an out-patient commitment order in 2008–2012 in six catchment areas in Norway, covering one-third of the Norwegian population aged 18 years or more. For a subsample of patients, we recorded use of in-patient care 3 years before and after their first-ever out-patient commitment. Results: Annual incidence varied between 20.7 and 28.4, and prevalence between 36.5 and 48.9, per 100 000 population aged 18 years or above. Rates differed significantly between catchment areas. Mean out-patient commitment duration was 727 days (s.d. = 889). Use of in-patient care decreased significantly in the 3 years after out-patient commitment compared with the 3 years before. Use of antipsychotic medication through the whole out-patient commitment period and fewer in-patient episodes in the 3 years before out-patient commitment predicted longer time to readmission. Conclusions: Mechanisms behind the pronounced variations in use of out-patient commitment between sites call for further studies. Use of in-patient care was significantly reduced in the 3 years after a first-ever out-patient commitment order was made. Declaration of interest: None.
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- Authors
- Riley, H., Sharashova, E., Rugkåsa, J., Nyttingnes, O., Christensen, T. B., Austegard, A.-T. A., Løvsletten, M., Lau, B., & Høyer, G.
- Affiliations
- University Hospital of North Norway (NO)
- Corresponding author
- Riley, Henriette
- ORCID
- Venue
- BJPsych Open
- Publisher
- Royal College of Psychiatrists
- Published
- 2019-09
- Volume
- 5
- Issue
- 5
- Pages
- e75-e75
- ISSN
- 2056-4724 (ISSN-L)
- PMC
- PMC6737513
- OpenAlex
- W2971459946
- Cited by
- 11
- References
- 25
- Citations by year
- 2026: 3 · 2025: 2 · 2023: 3 · 2022: 2 · 2021: 1
- FWCI
- 0.88
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BJPsych Open (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by-nc-nd)
- Funders
- Universitetet i Tromsø
- Helse Nord RHF
- Akershus Universitetssykehus
- Sykehuset Innlandet HF
- Helsedirektoratet
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- outpatient commitment, incidence and prevalence, hospital readmission, antipsychotic drugs, mental health services, Norway
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