A Network Analysis of Psychiatric Symptoms in Patients With Schizophrenia Treated With Antipsychotic Polypharmacy Using Propensity Score Matching: Findings From the Research on Asian Psychotropic Prescription Patterns (REAP) Study.
Journal
Asia-Pacific Psychiatry
Series/Report No.
Asia Pacific Psychiatry
Journal Volume
17
Journal Issue
3
Start Page
e70005
ISSN
1758-5872
Date Issued
2025-09
Author(s)
Li, Wen
Zhang, Qinge
Ungvari, Gabor S
Park, Seon-Cheol
Chee, Kok Yoon
Kallivayalil, Roy Abraham
Sim, Kang
He, Yan-Ling
Sartorius, Norman
Shinfuku, Naotaka
Lin, Shih-Ku
Avasthi, Ajit
Grover, Sandeep
Kato, Takahiro A
Ng, Chee H
Xiang, Yu-Tao
Abstract
Objectives: Antipsychotic polypharmacy (APP) is prevalent among patients with schizophrenia across countries in Asia. This study aimed to explore the relationships between psychiatric symptoms and APP using network analysis. Methods: Data on nine major psychiatric symptoms and the number of prescribed antipsychotics were extracted from the fourth survey of the Research on Asian Psychotropic Prescription Patterns (REAP-AP). A network model of the nine psychiatric symptoms was constructed for patients treated with APP and antipsychotic monotherapy (APM) respectively. The interconnections between psychiatric symptoms and APP use were further analyzed using network analysis. Results: A total of 1528 patients with schizophrenia treated with APP were matched with 1528 patients treated with APM in Asia. The top three central psychiatric symptoms in the networks of psychiatric symptoms were consistent, but in different orders for APP-treated patients (verbal aggression, hallucinations, and social/occupational dysfunction) and APM-treated patients (social/occupational dysfunction, verbal aggression, and hallucinations). Network analysis of APP and psychiatric symptoms revealed that disorganized/catatonic behavior was strongly linked with APP, followed by delusions, hallucinations, and verbal aggression. Conclusion: Psychiatric symptoms closely associated with APP included verbal aggression, grossly disorganized/catatonic behavior, delusions, and hallucinations. For patients with schizophrenia who are primarily exhibiting such symptoms, alternative appropriate treatment strategies should be considered.
Subjects
antipsychotic polypharmacy
network analysis
psychiatric symptoms
schizophrenia
Publisher
John Wiley and Sons Inc
Type
journal article