Length of mechanical restraint following haloperidol injections versus oral atypical antipsychotics for the initial treatment of acute schizophrenia: A propensity-matched analysis from the Japanese diagnosis procedure combination database |
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| Authors: | Mitsuhiro Nakamura Hideo Yasunaga Tadashi Haraguchi Shuntaro Ando Toru Sugihara Hiromasa Horiguchi Kazuhiko Ohe Shinya Matsuda Kiyohide Fushimi |
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| Affiliation: | 1. Department of Psychiatry, Yokohama Camellia Hospital, Kanagawa, Japan;2. Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;3. Department of Health Management and Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;4. Research Center for Child Mental Development, Chiba University Graduate School of Medicine, Chiba, Japan;5. Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Japan;6. Department of Urology, The University of Tokyo, Tokyo, Japan;g Department of Medical Informatics and Economics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;h Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Fukuoka, Japan;i Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan |
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| Abstract: | ![]()
Differences in effectiveness between haloperidol injection and oral atypical antipsychotics in the acute-phase treatment of schizophrenia are not well examined. We retrospectively investigated whether these treatment options affected the length of mechanical restraint. We used the Japanese Diagnosis Procedure Combination Database to identify schizophrenia patients who were involuntarily hospitalized and receiving mechanical restraint between July and December, 2006–2009. Data included patient demographics, use of antipsychotics, and number of days on which patients underwent mechanical restraint. Propensity score matching was performed to compare the number of days of mechanical restraint between the haloperidol injection group and the oral atypical antipsychotics group. We used survival analysis to examine whether the initial difference in treatment affected the number of days of mechanical restraint. Cox regression was performed to compare the concurrent effects of various factors. Among 1731 eligible patients, 574 were treated with haloperidol injections and 420 with atypical antipsychotics. Matching produced 274 patients in each group. Cox regression analysis showed that the initial therapeutic agents did not significantly affect the number of days of mechanical restraint. The results indicate that atypical antipsychotics were as effective as haloperidol injections in the acute-phase treatment of schizophrenia. |
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| Keywords: | Schizophrenia Involuntary admission Haloperidol Atypical antipsychotics Propensity score matching Survival analysis |
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