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Use of Clozapine in a State Child and Adolescent Psychiatric Hospital

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Abstract

We assessed the predictors of clozapine initiation among youth 18 years and younger within a state psychiatric hospital. Administrative data (n = 358) were evaluated of inpatients from a long-term state child and adolescent psychiatric hospital. We investigated 25 background and clinical patient characteristics to determine which factors predicted clozapine initiation following the first 21 days of hospital admission. A Cox proportional model was used to evaluate factors that independently predicted the hazard rate of clozapine initiation. Emergency medication administration during the first 3 weeks of admission, which was more common among the clozapine (84.9 %) than control (61.7 %) patients (p < 0.001), was associated with a significantly increased probability of clozapine initiation (Hazard Ratio = 1.9, 95 % Confidence Interval = 1.2–3.1). Use of a mood stabilizer during the first 3 weeks of the inpatient was non-significantly related to an increased probability of clozapine initiation (Hazard Ratio = 1.7, 95 % Confidence Interval = 1.0–2.9). In this setting, emergency medication use predicts clozapine initiation suggesting that it may be used to treat patients with aggressive behavior.

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Acknowledgments

We gratefully acknowledge Naila Dixon, Erica Tanne and Jules Ranz.

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Authors and Affiliations

  1. New York City Children’s Center, New York State Office of Mental Health, Brooklyn, NY, USA

    Vanessa Bobb

  2. Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA

    Michael Weinberg & Mark Olfson

  3. Department of Psychiatry, State University of New York, Upstate Medical University, Syracuse, NY, USA

    Stewart Gabel

  4. Department of Psychiatry, Albert Einstein College of Medicine, Bronx, NY, USA

    Harvey Kranzler

Authors
  1. Vanessa Bobb
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  2. Michael Weinberg
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  3. Stewart Gabel
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  4. Harvey Kranzler
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  5. Mark Olfson
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Correspondence to Vanessa Bobb.

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Bobb, V., Weinberg, M., Gabel, S. et al. Use of Clozapine in a State Child and Adolescent Psychiatric Hospital. Psychiatr Q 84, 343–349 (2013). https://doi.org/10.1007/s11126-012-9250-2

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  • DOI: https://doi.org/10.1007/s11126-012-9250-2

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