The British Journal of Psychiatry (2009) 195: 5-6. doi: 10.1192/bjp.bp.108.062968
© 2009 The Royal College of Psychiatrists
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REAPPRAISAL

End of the road for treatment-as-usual studies?{dagger}

Tom Burns

University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX. Email: tom.burns{at}psych.ox.ac.uk

Declaration of interest

None.

{dagger} See pp. 81–82, this issue.

ABSTRACT

Using treatment as usual (TAU) in trials has obscured the repeated finding that assertive outreach has never reduced hospitalisation when compared with treatment by multidisciplinary teams (community mental health teams, CMHTs). Its use has delayed recognising that CMHTs are the more cost-effective, evidence-based approach. The term should be abandoned and trials should compare two equally well-defined services.


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