TY  - JOUR
PY  - 2024//
TI  - History of suicidal behavior and clozapine prescribing among people with schizophrenia in China: a cohort study
JO  - BMC psychiatry
A1  - Tong, Jinghui
A1  - Wei, Lijing
A1  - Lin, Chen
A1  - Tong, Yongsheng
A1  - Yang, Fude
A1  - Yin, Yi
A1  - Tan, Yunlong
A1  - Wang, Zhiren
A1  - Tan, Shuping
A1  - Hong, L. Elliot
A1  - Chen, Song
A1  - Tian, Baopeng
A1  - Huang, Junchao
SP  - e440
EP  - e440
VL  - 24
IS  - 1
N2  - BACKGROUND: Clozapine is an off-label drug used in most countries to prevent suicide in individuals with schizophrenia. However, few studies have reported real-world prescription practices. This study aimed to explore the association between a history of suicidal behavior and clozapine prescribing during eight weeks of hospitalization for individuals with early-stage schizophrenia. <br><br>METHODS: This observational cohort study used routine health data collected from a mental health hospital in Beijing, China. The study included 1057 inpatients who had schizophrenia onset within 3 years. History of suicidal behavior was coded from reviewing medical notes according to the Columbia Suicide Severity Rating Scale. Information on antipsychotic use during hospitalization was extracted from the prescription records. Time to clozapine use was analyzed using Cox regression models adjusted for sociodemographic and clinical covariates. <br><br>RESULTS: The prevalence rates of self-harm, suicidal behavior, and suicide attempt were 12.3%, 7.5%, and 5.4%, respectively. A history of self-harm history was positively associated with clozapine uses upon admission (4.1% vs. 0.8%, exact p = 0.009). Among those who had not used clozapine and had no clozapine contraindication, A history of suicidal behavior increased the possibility of switch to clozapine within 56 days after admission (Hazard Ratio[95% CI], 6.09[2.08-17.83]) or during hospitalization (4.18[1.62-10.78]). <br><br>CONCLUSION: The use of clozapine for early-stage schizophrenia was more frequent among those with suicidal behavior than among those without suicidal behavior in China, although the drug instructions do not label its use for suicide risk.<p />  <p>Language: en</p>
LA  - en
SN  - 1471-244X
UR  - http://dx.doi.org/10.1186/s12888-024-05893-y
ID  - ref1
ER  -