High Risk, High Dose?-Pharmacotherapeutic Prescription Patterns of Offender and Non-Offender Patients with Schizophrenia Spectrum Disorder

Compared to acute or community settings, forensic psychiatric settings, in general, have been reported to make greater use of antipsychotic polypharmacy and/or high dose pharmacotherapy, including overdosing. However, there is a scarcity of research specifically on offender patients with schizophrenia spectrum disorders (SSD), although they make up a large proportion of forensic psychiatric patients. Our study, therefore, aimed at evaluating prescription patterns in offender patients compared to non-offender patients with SSD. After initial statistical analysis with null-hypothesis significance testing, we evaluated the interplay of the significant variables and ranked them in accordance with their predictive power through application of supervised machine learning algorithms. While offender patients received higher doses of antipsychotics, non-offender patients were more likely to receive polypharmacologic treatment as well as additional antidepressants and benzodiazepines. To the authors' knowledge, this is the first study to evaluate a homogenous group of offender patients with SSD in comparison to non-offender controls regarding patterns of antipsychotic and other psychopharmacologic prescription patterns.

Automated summary

Compared to acute or community settings, forensic psychiatric settings are more likely to use antipsychotic polypharmacy and/or high dose pharmacotherapy, including overdosing. This study evaluated prescription patterns in offender patients compared to non-offender patients with schizophrenia spectrum disorders (SSD). The results showed that offender patients received higher doses of antipsychotics, while non-offender patients were more likely to receive polypharmacologic treatment as well as additional antidepressants and benzodiazepines.