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Title: Clozapine Promotes Employability and Reduces Re-Offending Among Mentally-Disordered Offenders: Presented at CPA
URL: http://www.pslgroup.com/dg/22B706.htm
Doctor's Guide
September 9, 2008

By Thomas S. May

VANCOUVER -- September 9, 2008 -- The atypical antipsychotic clozapine helps promote institutional adjustment and reduces the probability of mentally disordered inmates committing an institutional offence, according to research presented here at the 58th Annual Meeting of the Canadian Psychiatric Association (CPA).

Also, these outcomes appear to be independent of clozapine's effect on psychiatric symptoms and psychopathology, said study researcher Mansfield Mela, MRCPsych, University of Saskatchewan, Saskatoon, Saskatchewan.

Dr. Mela and colleagues reviewed the hospital charts and correctional records of 98 inmates of a Canadian forensic psychiatric hospital who had been diagnosed with psychoses and received either clozapine or another antipsychotic.

The researchers analysed a number of clinical and correctional variables at 6 and 12 months after the initial dose.

A between-groups comparison revealed that patients who were treated with clozapine achieved less favourable outcomes in the Brief Psychiatric Rating Scale compared with those treated with other antipsychotics (P = .023).

However, treatment with clozapine was associated with greater employment income at 12 months (P = .008). Additionally, inmates treated with clozapine were less likely to commit institutional offences at up to 18 months (P < .001.)

These findings highlight the antihostility and antiaggressive properties of clozapine, according to Dr. Mela.

Although similar results have been obtained in previous studies, they used "proxy measures of antiaggression [such as lower security level needed, reduced time on restraints, etc]," he noted. By contrast, this study used a more direct measure -- namely, the number of physical and verbal aggressive episodes -- which remained significantly reduced even after 3 years of treatment, Dr. Mela said.

Dr. Mela also pointed out that the use of a change in pay scale level is indicative of better employability, and "lends itself to a robust function, improving rehabilitation strategy, which could be translated into the community."

Furthermore, "the cost-benefit analysis and the possible reduction of recidivism, when considered and factored in the population of mentally disordered offenders, can potentially change systems of care in the community and be beneficial to the patients, families, and society at large," he said. "This has implications for the direct, indirect, and intangible cost of crime and mental disorder."


[Presentation title: Clozapine Promotes Employability and Reduces Offending Among Mentally-Disordered Offenders. Abstract PS1A]

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