Current status and features of antipsychotic prescriptions in Japanese forensic psychiatric wards based on a forensic inpatient database.

IF 2 Q3 NEUROSCIENCES Neuropsychopharmacology Reports Pub Date : 2025-03-01 Epub Date: 2024-11-26 DOI:10.1002/npr2.12505
Koji Takeda, Hiroko Kashiwagi, Keisuke Takanobu, Ryotaro Kubota, Ryo Naoe, Yuji Yamada, Junko Koike, Toshiaki Kono, Yuki Kako, Naotsugu Hirabayasi
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Abstract

Aim: Psychopharmacotherapy plays an important role in the treatment of mentally disordered offenders (MDOs) with schizophrenia spectrum disorders. However, there have been few large-scale reports from multiple forensic psychiatric wards. This study aimed to clarify the current state of antipsychotic medications for MDOs with schizophrenia spectrum disorders in Japanese forensic psychiatric wards.

Methods: Medical information, including age, sex, psychiatric diagnosis, index offense, seclusion or restraint experience during hospitalization, and medication for patients discharged from 32 forensic wards nationwide between September 1, 2019 and December 31, 2021 was provided by the Database Scientific Utilization Project of Japanese forensic psychiatric wards. We analyzed the data of MDOs with schizophrenia spectrum disorders who were prescribed psychotropic medications at the time of discharge, especially focusing on comparing differences between the three groups (clozapine, long-acting injection (LAI), and other medications).

Results: A total of 362 MDOs with schizophrenia spectrum disorders were prescribed psychotropic medications at discharge. The prescription rates of clozapine and LAI were 23.2% and 24.9%, respectively. Additionally, the rate of antipsychotic polypharmacy was 37.8%. Among the three groups, the clozapine group had the highest rate of seclusion experience (46.4%), a long mean length of hospitalization (1758 days), and the lowest rate of antipsychotic polypharmacy (4.8%). Olanzapine was the most commonly prescribed antipsychotic medication.

Conclusion: This study revealed the current state of antipsychotic medications for MDOs admitted to forensic psychiatric wards in Japan. Future studies are needed to clarify the relevance of antipsychotic medications in the prognosis of MDOs.

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基于法医住院病人数据库的日本法医精神病病房抗精神病药物处方的现状和特点。
目的:精神药物疗法在治疗患有精神分裂症谱系障碍的精神失常罪犯(MDOs)方面发挥着重要作用。然而,很少有来自多个法医精神病病房的大规模报告。本研究旨在阐明日本法医精神病病房对患有精神分裂症谱系障碍的精神失常罪犯使用抗精神病药物的现状:日本法医精神病院数据库科学利用项目提供了2019年9月1日至2021年12月31日期间全国32家法医精神病院出院患者的医疗信息,包括年龄、性别、精神病诊断、指数罪行、住院期间的隔离或约束经历以及用药情况。我们分析了精神分裂症谱系障碍 MDO 在出院时接受精神药物治疗的数据,尤其关注比较三组药物(氯氮平、长效注射剂(LAI)和其他药物)之间的差异:共有 362 名患有精神分裂症谱系障碍的 MDO 在出院时接受了精神药物治疗。氯氮平和LAI的处方率分别为23.2%和24.9%。此外,抗精神病药物的多重用药率为 37.8%。在三组患者中,氯氮平组有过隔离经历的比例最高(46.4%),平均住院时间较长(1758 天),抗精神病药物多重使用率最低(4.8%)。奥氮平是最常用的抗精神病药物:本研究揭示了日本法医精神病病房收治的 MDO 的抗精神病药物治疗现状。今后的研究需要明确抗精神病药物与 MDO 预后的相关性。
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来源期刊
Neuropsychopharmacology Reports
Neuropsychopharmacology Reports Psychology-Clinical Psychology
CiteScore
3.60
自引率
4.00%
发文量
75
审稿时长
14 weeks
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