Antipsychotic Treatment Patterns and Aggressive Behavior Among Adolescents in Residential Facilities

  • Leslie Miller
  • Mark A. Riddle
  • David Pruitt
  • Al Zachik
  • Susan dosReis
Article

DOI: 10.1007/s11414-012-9314-y

Cite this article as:
Miller, L., Riddle, M.A., Pruitt, D. et al. J Behav Health Serv Res (2013) 40: 97. doi:10.1007/s11414-012-9314-y
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Abstract

This study examined the association between acute aggressive behavior patterns of 145 adolescents in residential treatment facilities with use of and changes in antipsychotic medication for the chronic management of aggression. Seclusion/restraint (S/R) frequency over 12 months was used to categorize youth into none, low, moderate, and high S/R groups. Data were analyzed using longitudinal mixed effects logistic regression models that allowed for intra-subject variability over time. The high and moderate S/R groups were significantly more likely to receive antipsychotics, get higher doses, and have changes in medication compared with the none S/R group. Increases in antipsychotic dose were associated with a lower likelihood of changes in antipsychotic medication over time. Despite persistent antipsychotic use at higher doses, youth in the high and moderate S/R groups continued to be secluded/restrained frequently. The findings question the adequacy of these medications in managing aggressive behavior.

Copyright information

© National Council for Community Behavioral Healthcare 2013

Authors and Affiliations

  • Leslie Miller
    • 1
  • Mark A. Riddle
    • 2
  • David Pruitt
    • 3
  • Al Zachik
    • 4
  • Susan dosReis
    • 5
  1. 1.Johns Hopkins University School of Medicine, Division of Child and Adolescent PsychiatryBaltimoreUSA
  2. 2.Johns Hopkins University School of Medicine, Division of Child and Adolescent PsychiatryBaltimoreUSA
  3. 3.Division of Child and Adolescent PsychiatryUniversity of Maryland School of MedicineBaltimoreUSA
  4. 4.Maryl and Mental Hygiene Administration Spring Grove Hospital CenterCatonsvilleUSA
  5. 5.Department of Pharmaceutical Health Services ResearchUniversity of Maryland School of PharmacyBaltimoreUSA