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Post-discharge pharmacological treatment discontinuation of forensic psychiatric patients in Sweden
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- Noland, Ebba (author)
- Umeå universitet,Institutionen för socialt arbete,Sundsvall Forensic Psychiatric Centre, Region Västernorrland, Sundsvall, Sweden
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- Virtanen, Suvi (author)
- Karolinska Institutet
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- Klötz Logan, Fia (author)
- Sundsvall Forensic Psychiatric Centre, Region Västernorrland, Sundsvall, Sweden
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- Frontiers Media S.A. 2024
- 2024
- English.
- In: Frontiers in Psychiatry. - : Frontiers Media S.A.. - 1664-0640. ; 15
- Journal article (peer-reviewed)
Abstract
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- Introduction: Most forensic psychiatric patients have chronic psychiatric disorders that require long-term pharmacological treatment even after discharge from care. However, the prevalence and correlates of post-discharge medication discontinuation in this patient group remain unclear.Objective: The aim of this study was to investigate the prevalence and correlates of post-discharge discontinuation of pharmacological treatment in forensic psychiatric patients in Sweden.Methods: Data on individuals discharged from forensic psychiatric care between 2009 and 2018 (n = 1,142) with ongoing pharmacological treatment at the time of discharge (n = 856) were identified from the Swedish National Forensic Psychiatric Register. Cox regression models were used to estimate the association between patient characteristics and medication discontinuation.Results: Of the 856 individuals with pharmacological treatment at discharge, 488 (57%) discontinued treatment within 2 years of discharge. Factors associated with an increased risk of treatment discontinuation varied between different types of psychotropic medications: the most important correlate was comorbidity between psychosis and personality disorder. Higher age at discharge, longer length of stay, having a history of several psychiatric care episodes, having a trustee, having a limited guardian, and a residing in a supported living accommodation at the time of discharge were associated with a decreased rate of medication discontinuation. This applied for antipsychotics, antidepressants, antiepileptics, and any psychotropic medication, but not for psychostimulants or drugs used in addictive disorders.Conclusion: For many former forensic psychiatric patients, there are situational factors associated with medication discontinuation. This insight holds significance for professionals who are involved in pre-discharge planning within forensic psychiatric care and those who interact with this cohort of former patients post-discharge.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Psykiatri (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Psychiatry (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
Keyword
- discharge
- forensic psychiatry
- medication discontinuation
- mentally disordered offender
- pharmacological treatment discontinuation
- psychotropic medications
Publication and Content Type
- ref (subject category)
- art (subject category)
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