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首页> 外文期刊>The journal of clinical psychiatry >Risk of arrest in persons with schizophrenia and bipolar disorder in a Florida Medicaid program: the role of atypical antipsychotics, conventional neuroleptics, and routine outpatient behavioral health services.
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Risk of arrest in persons with schizophrenia and bipolar disorder in a Florida Medicaid program: the role of atypical antipsychotics, conventional neuroleptics, and routine outpatient behavioral health services.

机译：在佛罗里达医疗补助计划中，精神分裂症和双相情感障碍患者被捕的风险：非典型抗精神病药，常规抗精神病药和常规门诊行为健康服务的作用。

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OBJECTIVE: To examine (1) arrest outcomes for adults with schizophrenia and bipolar disorder who were treated with first-generation antipsychotics (FGAs) or second-generation atypical antipsychotics (SGAs) and (2) the interaction between medication class and outpatient services in a Florida Medicaid program. METHOD: In a secondary data analysis, Florida Medicaid data covering the period from July 1, 2002, to March 31, 2008, were used to identify persons diagnosed with schizophrenia, schizoaffective disorder, and bipolar disorder and to examine antipsychotic medication episodes lasting at least 60 days. There were 93,999 medication episodes in the population examined (N = 36,519). Medication episodes were coded as (1) SGA-aripiprazole, clozapine, olanzapine, paliperidone, quetiapine, risperidone, risperidone long-acting therapy, or ziprasidone; or (2) FGA-any other antipsychotic medication. Outpatient services were defined as the proportion of 30-day periods of each medication episode with at least 1 behavioral health visit. Survival analyses were used to analyze the data, and they were adjusted for the baseline propensity for receiving an SGA. RESULTS: Second-generation antipsychotic episodes were not associated with reduced arrests compared to FGA episodes; however, the interaction between outpatient services and SGA episodes was significant (hazard ratio [HR] = 0.68; 95% CI, 0.50-0.93; P = .02) such that an SGA episode with an outpatient visit during at least 80% of every 30-day period of the episode was associated with reduced arrests compared to SGA episodes with fewer outpatient services. There was no significant effect for concurrent FGA episodes and outpatient treatment (HR = 0.81; 95% CI, 0.60-1.10; P = .18). Substance use, poor refill compliance, and prior arrest increased risk of subsequent arrest. CONCLUSIONS: The interaction between outpatient visits and treatment with SGAs was significantly associated with reduced arrests. These findings indicate the importance of concurrent antipsychotic medications and outpatient services to affect arrest outcomes for adults with schizophrenia and bipolar disorder.
机译：目的：研究（1）接受第一代抗精神病药（FGA）或第二代非典型抗精神病药（SGA）治疗的精神分裂症和双相情感障碍的成年人的逮捕结果，以及（2）药物类别与门诊服务之间的相互作用佛罗里达医疗补助计划。方法：在辅助数据分析中，使用了2002年7月1日至2008年3月31日期间的佛罗里达医疗补助数据，以鉴定出患有精神分裂症，精神分裂症和双相情感障碍的人，并检查至少持续持续的抗精神病药物发作60天在接受检查的人群中有93,999次用药事件（N = 36,519）。药物治疗事件编码为（1）SGA-阿立哌唑，氯氮平，奥氮平，帕潘立酮，喹硫平，利培酮，利培酮长效疗法或齐拉西酮;或（2）FGA-其他任何抗精神病药物。门诊服务定义为每次服药至少30次，至少进行1次行为健康就诊的比例。生存分析用于分析数据，并针对接受SGA的基线倾向进行了调整。结果：与FGA发作相比，第二代抗精神病发作与减少的逮捕无关。但是，门诊服务与SGA发作之间的相互作用非常显着（风险比[HR] = 0.68; 95％CI，0.50-0.93; P = .02），因此在每次门诊中至少有80％发生SGA发作且有门诊患者与SGA发作相比，发作期30天与门诊服务较少的发作减少相关。并发的FGA发作和门诊治疗均无显着影响（HR = 0.81; 95％CI，0.60-1.10; P = .18）。物质使用，较差的笔芯顺应性以及先前的逮捕增加了后续逮捕的风险。结论：门诊就诊与SGA治疗之间的相互作用与逮捕的减少显着相关。这些发现表明，同时使用抗精神病药物和门诊服务对影响精神分裂症和躁郁症成人的逮捕结果非常重要。

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