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dc.contributor.authorCavaliere, Vincent S
dc.contributor.authorGlassman, Matthew
dc.contributor.authorDiPaula, Bethany A
dc.contributor.authorMackowick, Marie
dc.contributor.authorWehring, Heidi J
dc.contributor.authorLiu, Fang
dc.contributor.authorChen, Shuo
dc.contributor.authorPark, Jaeboon
dc.contributor.authorLove, Raymond C
dc.contributor.authorRichardson, Charles M
dc.contributor.authorVyas, Gopal
dc.contributor.authorKearns, Ann Marie
dc.contributor.authorKelly, Deanna L
dc.date.accessioned2022-04-11T15:52:26Z
dc.date.available2022-04-11T15:52:26Z
dc.date.issued2022-03-28
dc.identifier.urihttp://hdl.handle.net/10713/18532
dc.description.abstractIntroduction: Patients with severe mental illness are falsely characterized as aggressive by the media, perpetuating stigma. While exaggerated, some patients with severe mental illness are more aggressive without treatment. Clozapine may have a unique anti-aggressive effect in patients with schizophrenia-related disorders, independent of antipsychotic or sedative effects. Limited data in forensic and involuntary committed patients is currently available. Purpose: This study evaluates clozapine's effects on hostility and aggression in court-ordered Black patients. Methods: This study analyzes a subgroup of Black patients from a larger prospective 24-week open-label clozapine study. All patients were involuntarily committed and enrolled from two participating state psychiatric hospitals. The primary outcome measured was total use of ‘as needed’ (PRN) or ‘immediate need’ (STAT) medications for aggression/hostility. Secondary outcomes included number and duration of seclusion and restraint (S/R) episodes, and changes in Brief Psychiatric Rating Scale (BPRS) hostility factor score. Results: Sixty-nine patients were included in our analysis. Significant reductions were noted in PRN/STAT medication use over time (χ2 = 6.90; p = 0.008) and the BPRS hostility factor score was reduced by 30% over the 24 weeks (F = 4.34, df = 62, p = 0.002). Conclusions: Treatment with clozapine effectively reduced hostility and aggression within this cohort of involuntarily committed Black patients with mental illness compared to baseline. Specifically, it helped lower the total number of PRN/STAT medication administrations and improved clinician-rated hostility factor scores on the BPRS. Our findings are pertinent as data in forensic settings is lacking and Black patients have been infrequently included in large prospective clinical trials with clozapine. ClinicalTrials.gov identifier: NCT02404155.en_US
dc.description.urihttps://doi.org/10.1016/j.schres.2022.03.006en_US
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relation.ispartofSchizophrenia Researchen_US
dc.rightsCopyright © 2022. Published by Elsevier B.V.en_US
dc.subjectAfrican Americansen_US
dc.subjectAggressionen_US
dc.subjectClozapineen_US
dc.subjectForensic psychiatryen_US
dc.subjectSchizophreniaen_US
dc.subjectViolenceen_US
dc.titleAnti-aggressive effects of clozapine in involuntarily committed black patients with severe mental illness.en_US
dc.typeArticleen_US
dc.identifier.doi10.1016/j.schres.2022.03.006
dc.identifier.pmid35358857
dc.source.journaltitleSchizophrenia research
dc.source.volume243
dc.source.beginpage163
dc.source.endpage169
dc.source.countryNetherlands


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