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- Laehteenvuo, M, et al.
(författare)
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Associations between antipsychotic use, substance use and relapse risk in patients with schizophrenia: real-world evidence from two national cohorts
- 2022
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Ingår i: The British journal of psychiatry : the journal of mental science. - : Royal College of Psychiatrists. - 1472-1465. ; 221:6, s. 758-765
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Tidskriftsartikel (refereegranskat)abstract
- Research on the effectiveness of pharmacotherapies for schizophrenia and comorbid substance use disorder (SUD) is very sparse, and non-existent on the prevention of the development of SUDs in patients with schizophrenia.AimsTo compare the real-world effectiveness of antipsychotics in schizophrenia in decreasing risk of developing an initial SUD, and psychiatric hospital admission and SUD-related hospital admission among patients with an SUD.MethodTwo independent national cohorts including all persons diagnosed with schizophrenia (N = 45 476) were followed up for 22 (Finland: 1996–2017) and 11 (Sweden: 2006–2016) years. Risk of developing an SUD was calculated with between-individual models, and risks of psychiatric and SUD-related hospital admission were calculated with within-individual models, using Cox regression and adjusted hazard ratios (aHRs) for using versus not using certain antipsychotics.ResultsFor patients with schizophrenia without an SUD, clozapine use (Finland: aHR 0.20, 95% CI 0.16–0.24, P < 0.001; Sweden: aHR 0.35, 95% CI 0.24–0.50, P < 0.001) was associated with lowest risk of developing an initial SUD in both countries. Antipsychotic polytherapy was associated with second lowest risk (aHR 0.54, 95% CI 0.44–0.66) in Sweden, and third lowest risk (aHR 0.47, 95% CI 0.42–0.53) in Finland. Risk of relapse (psychiatric hospital admission and SUD-related hospital admission) were lowest for clozapine, antipsychotic polytherapy and long-acting injectables in both countries. Results were consistent across both countries.ConclusionsClozapine and antipsychotic polytherapy are most strongly associated with reduced risk of developing SUDs among patients with schizophrenia, and with lower relapse rates among patients with both diagnoses.
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- Vaurio, O, et al.
(författare)
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Female Psychopathy and Mortality
- 2022
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Ingår i: Frontiers in psychiatry. - : Frontiers Media SA. - 1664-0640. ; 13, s. 831410-
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Tidskriftsartikel (refereegranskat)abstract
- The mortality of female psychopaths has scarcely been investigated. To estimate the association between psychopathy and mortality, data from subjects having been in forensic psychiatric assessments at Niuvanniemi Hospital during 1984–1993 were linked to the data from the National Death Registry. Sixteen psychopathic females scoring 25 points or higher in the PCL-R scale (psychopaths) were followed up for a median (IQR) 21 (17–25) years and 41 offenders scoring <25 on the PCL-R (non-psychopathic offenders) for 22 (17–25) years. In both psychopath and non-psychopath offender groups, the mortality was significantly higher (p < 0.01) than in the general population, being over 12-fold among psychopathic and over 6-fold among the non-psychopathic offenders.
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