Comparative effect of antipsychotics on risk of self-harm among patients with schizophrenia
Journal
Acta Psychiatrica Scandinavica
Journal Volume
137
Journal Issue
4
Pages
296-305
Date Issued
2018
Author(s)
Ma C.-H.
Tsai H.-J.
Abstract
Objective: To investigate the association of different antipsychotic treatments with hospitalization due to self-harm among patients with schizophrenia. Method: This retrospective cohort study was based on Taiwan's universal health insurance database. Patients aged 15–45 years with a newly diagnosed schizophrenic disorder in 2001–2012 were included. The study outcome was the first hospitalization due to self-harm or undetermined injury after the diagnosis of schizophrenic disorders. The exposure status of antipsychotics was modeled as a time-dependent variable. The analyses were stratified by antipsychotic dosage based on defined daily dose (DDD). Results: Among 70 380 patients with a follow-up of 500 355 person-years, 2272 self-harm hospitalization episodes were identified. Compared with none or former use, current use of several second-generation antipsychotics with a dose of one DDD or above, including amisulpride, aripiprazole, clozapine, risperidone, and sulpiride, was associated with decreased risk of self-harm hospitalization, with clozapine showing the strongest effect (adjusted rate ratio = 0.26, 95% confidence interval 0.15–0.47). Conclusion: The protective effect on self-harm may vary across different antipsychotics. Further studies are needed to replicate the findings. ? 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
SDGs
Other Subjects
amisulpride; anticonvulsive agent; antidepressant agent; aripiprazole; benzodiazepine; chlorpromazine; clotiapine; clozapine; flupentixol; haloperidol; lithium; mood stabilizer; neuroleptic agent; olanzapine; quetiapine; risperidone; sulpiride; zotepine; clozapine; neuroleptic agent; adolescent; adult; Article; automutilation; cohort analysis; comparative study; drug efficacy; female; follow up; hospitalization; human; incidence; major clinical study; male; priority journal; retrospective study; risk factor; schizophrenia; automutilation; middle aged; public health; risk; schizophrenia; statistics and numerical data; Taiwan; young adult; Adolescent; Adult; Antipsychotic Agents; Clozapine; Female; Follow-Up Studies; Hospitalization; Humans; Male; Middle Aged; National Health Programs; Risk; Schizophrenia; Self-Injurious Behavior; Taiwan; Young Adult
Publisher
Blackwell Publishing Ltd
Type
journal article