Clozapine Use and Forensic Outcomes in Psychiatric Inpatients Deemed Incompetent to Stand Trial.

Autor:	Singh A; Dr. Singh is Assistant Medical Director, DSH-Napa, Dr. Delgado is Senior Psychologist, Supervisor, Clinical Operations, Dr. Meyer is Psychopharmacology Consultant, and Dr. Schwartz is Psychopharmacology Consultant, California Department of State Hospitals, Patton, CA. Dr. Ventura is Data Analysis Supervisor, and Mr. Williams is Staff Research Associate, Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, Davis, CA., Delgado D; Dr. Singh is Assistant Medical Director, DSH-Napa, Dr. Delgado is Senior Psychologist, Supervisor, Clinical Operations, Dr. Meyer is Psychopharmacology Consultant, and Dr. Schwartz is Psychopharmacology Consultant, California Department of State Hospitals, Patton, CA. Dr. Ventura is Data Analysis Supervisor, and Mr. Williams is Staff Research Associate, Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, Davis, CA., Ventura MI; Dr. Singh is Assistant Medical Director, DSH-Napa, Dr. Delgado is Senior Psychologist, Supervisor, Clinical Operations, Dr. Meyer is Psychopharmacology Consultant, and Dr. Schwartz is Psychopharmacology Consultant, California Department of State Hospitals, Patton, CA. Dr. Ventura is Data Analysis Supervisor, and Mr. Williams is Staff Research Associate, Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, Davis, CA., Schwartz E; Dr. Singh is Assistant Medical Director, DSH-Napa, Dr. Delgado is Senior Psychologist, Supervisor, Clinical Operations, Dr. Meyer is Psychopharmacology Consultant, and Dr. Schwartz is Psychopharmacology Consultant, California Department of State Hospitals, Patton, CA. Dr. Ventura is Data Analysis Supervisor, and Mr. Williams is Staff Research Associate, Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, Davis, CA., Williams J; Dr. Singh is Assistant Medical Director, DSH-Napa, Dr. Delgado is Senior Psychologist, Supervisor, Clinical Operations, Dr. Meyer is Psychopharmacology Consultant, and Dr. Schwartz is Psychopharmacology Consultant, California Department of State Hospitals, Patton, CA. Dr. Ventura is Data Analysis Supervisor, and Mr. Williams is Staff Research Associate, Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, Davis, CA., Meyer JM; Dr. Singh is Assistant Medical Director, DSH-Napa, Dr. Delgado is Senior Psychologist, Supervisor, Clinical Operations, Dr. Meyer is Psychopharmacology Consultant, and Dr. Schwartz is Psychopharmacology Consultant, California Department of State Hospitals, Patton, CA. Dr. Ventura is Data Analysis Supervisor, and Mr. Williams is Staff Research Associate, Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, Davis, CA. jmmeyer@ucsd.edu.
Jazyk:	angličtina
Zdroj:	The journal of the American Academy of Psychiatry and the Law [J Am Acad Psychiatry Law] 2022 Sep; Vol. 50 (3), pp. 427-433. Date of Electronic Publication: 2022 Jul 07.
DOI:	10.29158/JAAPL.210123-21
Abstrakt:	Referrals for competency restoration increased in the past decade, with the majority of incompetent to stand trial (IST) patients having schizophrenia; 25 percent of schizophrenia patients are treatment resistant. Clozapine is superior to other antipsychotics for treatment resistance but remains underutilized, particularly in forensic settings. Despite the impact of treatment resistance on the legal system, the literature on clozapine for IST patients is limited to two papers comprising 26 patients. A retrospective chart review was conducted of all IST admissions to a California hospital for 2014 to -2018, examining clinical and forensic outcomes in those newly started on clozapine and discharged. There were 191 new clozapine starts among IST patients, 92.7 percent of whom were diagnosed with schizophrenia or another psychosis. Over 90 percent were discharged on clozapine, and 36.1 percent were discharged on clozapine as trial competent; moreover, this cohort also had the shortest length of stay. This analysis indicates that most IST patients needing clozapine can be successfully treated, with a substantial proportion restored to trial competency. These data and earlier studies reinforce the concept that forensic programs have a medical duty to offer IST patients with severe mental illness a clozapine trial when indications exist for its use. (© 2022 American Academy of Psychiatry and the Law.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu