Associations between individual antipsychotics and the risk of arrests and convictions of violent and other crime: a nationwide within-individual study of 74 925 persons.
Antipsychotics
clozapine
crime
effectiveness
pharmacoepidemiology
violence
Journal
Psychological medicine
ISSN: 1469-8978
Titre abrégé: Psychol Med
Pays: England
ID NLM: 1254142
Informations de publication
Date de publication:
11 Mar 2021
11 Mar 2021
Historique:
entrez:
11
3
2021
pubmed:
12
3
2021
medline:
12
3
2021
Statut:
aheadofprint
Résumé
Individuals diagnosed with psychiatric disorders who are prescribed antipsychotics have lower rates of violence and crime but the differential effects of specific antipsychotics are not known. We investigated associations between 10 specific antipsychotic medications and subsequent risks for a range of criminal outcomes. We identified 74 925 individuals who were ever prescribed antipsychotics between 2006 and 2013 using nationwide Swedish registries. We tested for five specific first-generation antipsychotics (levomepromazine, perphenazine, haloperidol, flupentixol, and zuclopenthixol) and five second-generation antipsychotics (clozapine, olanzapine, quetiapine, risperidone, and aripiprazole). The outcomes included violent, drug-related, and any criminal arrests and convictions. We conducted within-individual analyses using fixed-effects Poisson regression models that compared rates of outcomes between periods when each individual was either on or off medication to account for time-stable unmeasured confounders. All models were adjusted for age and concurrent mood stabilizer medications. The relative risks of all crime outcomes were substantially reduced [range of adjusted rate ratios (aRRs): 0.50-0.67] during periods when the patients were prescribed antipsychotics v. periods when they were not. We found that clozapine (aRRs: 0.28-0.44), olanzapine (aRRs: 0.46-0.72), and risperidone (aRRs: 0.53-0.64) were associated with lower arrest and conviction risks than other antipsychotics, including quetiapine (aRRs: 0.68-0.84) and haloperidol (aRRs: 0.67-0.77). Long-acting injectables as a combined medication class were associated with lower risks of the outcomes but only risperidone was associated with lower risks of all six outcomes (aRRs: 0.33-0.69). There is heterogeneity in the associations between specific antipsychotics and subsequent arrests and convictions for any drug-related and violent crimes.
Sections du résumé
BACKGROUND
BACKGROUND
Individuals diagnosed with psychiatric disorders who are prescribed antipsychotics have lower rates of violence and crime but the differential effects of specific antipsychotics are not known. We investigated associations between 10 specific antipsychotic medications and subsequent risks for a range of criminal outcomes.
METHODS
METHODS
We identified 74 925 individuals who were ever prescribed antipsychotics between 2006 and 2013 using nationwide Swedish registries. We tested for five specific first-generation antipsychotics (levomepromazine, perphenazine, haloperidol, flupentixol, and zuclopenthixol) and five second-generation antipsychotics (clozapine, olanzapine, quetiapine, risperidone, and aripiprazole). The outcomes included violent, drug-related, and any criminal arrests and convictions. We conducted within-individual analyses using fixed-effects Poisson regression models that compared rates of outcomes between periods when each individual was either on or off medication to account for time-stable unmeasured confounders. All models were adjusted for age and concurrent mood stabilizer medications.
RESULTS
RESULTS
The relative risks of all crime outcomes were substantially reduced [range of adjusted rate ratios (aRRs): 0.50-0.67] during periods when the patients were prescribed antipsychotics v. periods when they were not. We found that clozapine (aRRs: 0.28-0.44), olanzapine (aRRs: 0.46-0.72), and risperidone (aRRs: 0.53-0.64) were associated with lower arrest and conviction risks than other antipsychotics, including quetiapine (aRRs: 0.68-0.84) and haloperidol (aRRs: 0.67-0.77). Long-acting injectables as a combined medication class were associated with lower risks of the outcomes but only risperidone was associated with lower risks of all six outcomes (aRRs: 0.33-0.69).
CONCLUSIONS
CONCLUSIONS
There is heterogeneity in the associations between specific antipsychotics and subsequent arrests and convictions for any drug-related and violent crimes.
Identifiants
pubmed: 33691828
doi: 10.1017/S0033291721000556
pii: S0033291721000556
pmc: PMC9811342
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1-9Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 202836/Z/16/Z
Pays : United Kingdom
Références
Psychol Med. 2015 Aug;45(11):2447-57
pubmed: 25851504
Am J Psychiatry. 2019 Sep 1;176(9):694-701
pubmed: 31014102
JAMA Psychiatry. 2020 Apr 1;77(4):359-367
pubmed: 31940015
J Clin Psychiatry. 1994 Sep;55 Suppl B:47-52
pubmed: 7961573
Int J Neuropsychopharmacol. 2012 Oct;15(9):1351-71
pubmed: 22339930
Acta Psychiatr Scand. 2020 May;141(5):432-438
pubmed: 32092153
Eur Neuropsychopharmacol. 2011 Sep;21(9):655-79
pubmed: 21896369
Lancet. 2014 Sep 27;384(9949):1206-14
pubmed: 24816046
JAMA Psychiatry. 2019 May 1;76(5):499-507
pubmed: 30785608
Psychol Methods. 2018 Sep;23(3):480-504
pubmed: 28301199
Pharmacoepidemiol Drug Saf. 2007 Jul;16(7):726-35
pubmed: 16897791
Schizophr Bull. 2020 Feb 26;46(2):303-310
pubmed: 31150553
Int J Epidemiol. 2008 Jun;37(3):624-6
pubmed: 18316349
Lancet Psychiatry. 2018 Oct;5(10):797-807
pubmed: 30115598
Nord J Psychiatry. 2005;59(6):457-64
pubmed: 16316898
Lancet Psychiatry. 2015 Mar;2(3):224-32
pubmed: 26236648
Psychol Med. 2020 Sep;50(12):2028-2033
pubmed: 31462346
Mol Psychiatry. 2016 Sep;21(9):1251-6
pubmed: 26666206
Psychol Med. 2011 Jan;41(1):97-105
pubmed: 20334717
Schizophr Bull. 2017 Sep 1;43(5):1002-1010
pubmed: 28637202
Trauma Violence Abuse. 2020 Oct;21(4):754-768
pubmed: 30122119
Psychol Med. 2012 Aug;42(8):1663-73
pubmed: 22115074
Mol Psychiatry. 2021 Aug;26(8):4487-4495
pubmed: 31712719
PLoS One. 2013;8(2):e55942
pubmed: 23418482
Lancet. 2012 Jun 2;379(9831):2063-71
pubmed: 22560607
Schizophr Bull. 2018 Apr 6;44(3):603-619
pubmed: 29868849
J Clin Psychiatry. 2016;77(suppl 3):1-24
pubmed: 27732772
Neuropsychol Rehabil. 2014;24(3-4):445-63
pubmed: 23883189
Arch Gen Psychiatry. 2003 Jan;60(1):82-91
pubmed: 12511175
Psychol Med. 2006 Oct;36(10):1417-25
pubmed: 16863597
J Exp Anal Behav. 2019 Mar;111(2):192-206
pubmed: 30758051
Biol Psychiatry. 2019 Sep 1;86(5):335-343
pubmed: 31155139
World Psychiatry. 2018 Jun;17(2):149-160
pubmed: 29856543
Psychol Med. 2018 Oct;48(13):2202-2212
pubmed: 29254510
Schizophr Bull. 2017 Sep 1;43(5):1011-1020
pubmed: 28575527
JAMA. 2009 May 20;301(19):2016-23
pubmed: 19454640
Eur J Epidemiol. 2016 Feb;31(2):125-36
pubmed: 26769609
Lancet Psychiatry. 2017 Sep;4(9):694-705
pubmed: 28736102
JAMA Psychiatry. 2016 Aug 1;73(8):796-803
pubmed: 27410165
BMJ Open. 2015 Jun 22;5(6):e007520
pubmed: 26100027
Acta Psychiatr Scand. 2011 Dec;124(6):447-53
pubmed: 21838734
Lancet. 2019 Sep 14;394(10202):939-951
pubmed: 31303314
BMC Public Health. 2011 Jun 09;11:450
pubmed: 21658213