Nationwide study on antipsychotic polypharmacy among forensic psychiatric patients

Figures & data

Figure 1. Flowchart for nationwide study on polypharmacy among Greenlandic forensic psychiatric patients diagnosed with schizophrenia or other F2 diagnosis. Cross-sectional study, February 29th 2020.

Table 1. Comparison of Greenlandic forensic patients with an F2 ICD-10 diagnosis in antipsychotic mono versus polypharmacy treatment. Cross- sectional study February 29th 2020.

	Total N = 74 n (%)	APM^1 N = 48 n (%)	APP^2 N = 26 n (%)	p-value
Demographic and clinical characteristics
Gender
Male	61 (82)	40 (83)	21 (81)	0.760^b
Educational level*
No education after primary school	56 (78)	34 (74)	22 (85)	0.383^b
Education after primary school	16 (22)	12 (26)	4 (15)
Admission status
Outpatient, Greenland	62 (84)	42 (88)	20 (77)	0.247 ^b
In-patient Aarhus University Hospital, Denmark	8 (11)	5 (10)	3 (11)
In-patient, Dronning Ingrids Hospital, Greenland	4 (5)	1 (2)	3 (11)
Primary F2 ICD-10 diagnose
Schizophrenia	66 (89)	43 (90)	23 (89)	1.000 ^b
Other F2 diagnose	8 (11)	5 (10)	3 (11)
Substance use disorder
Yes	72 (97)	46 (96)	26 (100)	0.538^b
No	2 (3)	2 (4)	0 (0)
Forensic characteristics
Index offence*
Non-violent	2 (3)	2 (4)	0 (0)	0.323^b
Violent	54 (75)	37 (78)	17 (68)
Sexual offence	16 (22)	8 (17)	8 (32)
Criminally convicted prior to index offence
Yes	43 (58)	25 (52)	18 (69)	0.154^a
No	31 (42)	23 (48)	8 (31)

*Missing values. 1. Antipsychotic monotherapy defined as only one antipsychotic prescription. 2.Antipsychotic polytherapy defined as two or more antipsychotic prescription. a. Chi² test. b.Fisher’s exact test.

Table 2. Comparison of prescribed antipsychotic medication among Greenlandic forensic patients with an F2 ICD-10 diagnosis in antipsychotic mono versus polypharmacy treatment. Cross- sectional study February 29th 2020.

	Total N = 74 n (%)	APM^1 N = 48 n (%)	APP^2 N = 26 n (%)	p-value
Form of administration
Oral only	22 (30)	17 (35)	5 (19)	0.146^a
LAI^3 ≥1	52 (70)	31 (65)	21 (81)
Prescribed a first-generation antipsychotic
Yes	14 (19)	5 (10)	9 (35)	0.011^a
No	60 (81)	43 (90)	17 (65)
Prescribed a second-generation antipsychotic (SGA)
Yes	69 (93)	43 (90)	26 (100)	0.106 ^b
No	5 (7)	5 (10)	0 (0)
High-dose (PDD:DDD >1.5)
High	21 (28)	14 (29)	7 (27)	0.838^a
Low	53 (72)	34 (71)	19 (73)
Prescribed clozapine
Yes	23 (31)	10 (21)	13 (50)	0.010
No	51 (69)	38 (79)	13 (50)

1. Antipsychotic monotherapy defined as only one antipsychotic prescription. 2. Antipsychotic polytherapy defined as two or more antipsychotic prescriptions. 3. Long acting injections.

Table 3. Comparison of antipsychotic prescription pattern among Greenlandic forensic psychiatric patients with an F2 ICD-10 diagnosis in antipsychotic monotherapy versus polypharmacy treatment. Cross- sectional study February 29th 2020.

Type of antipsychotic	Prescriptions (n)	APM (n)	APP (n)	p-value
FGA^1
Haloperidol (LAI)	1	0	1	0.351^b
Perphenazine (LAI)	4	2	2	0.609^b
Zuclopenthixol	1	0	1	0.351^b
Zuclopenthixol (LAI)	9	3	6	0.059^b
SGA^2
Clozapine	23	10	13	0.010^a
Olanzapine	12	3	9	0.003^b
Olanzapine (LAI)	6	3	3	0.659^b
Quetiapine	3	1	2	0.281^b
Risperidone	5	3	2	1.000^b
Risperidone (LAI)	20	14	6	0.785^b
Aripiprazole	4	0	4	0.013^b
Aripiprazole (LAI)	3	3	0	0.548^b
Paliperidone	1	0	1	0.351^b
Paliperidone (LAI)	7	6	1	0.410^b
Other
Levomepromazine	1	0	1	0.351^b

1.First generation antipsychotics, 2. Second generation antipsychotics. a. Chi2 test. b Fisher’s exact test.