Does clozapine promote employability and reduce offending among mentally disordered offenders?
OBJECTIVE
To compare employment pay, count of infractions, and clinical symptoms in psychiatric inmates treated with clozapine or other antipsychotics after 6 months of treatment.


METHODS
Clinical charts and institutional offence records of psychiatric inmates (n = 98), comprised of those on clozapine (n = 65) and on other antipsychotics (n = 33), were reviewed at baseline and after 6 months of treatment. The outcome measures used were Brief Psychiatric Rating Scale (BPRS) scores, employment pay, medication compliance, and the frequency of institutional offences. A binary logistic regression model was used to analyze a categorical change in pay variable, while a negative binomial model was used to analyze the frequency of infractions.


RESULTS
Treatment with clozapine was associated with greater odds of a pay increase (OR = 3.13; 95% CI 1.3 to 7.53, P = 0.01). However, patients on other antipsychotics had a more favourable improvement in BPRS (F = 5.44, df = 1,57, P = 0.02). Patients on other antipsychotics also had a higher count of posttreatment offences (Incidence Rate Ratio = 2.22; 95% CI 1.11 to 4.41, P = 0.02).


CONCLUSIONS
Clozapine probably has a favourable effect on inmate behaviour and institutional adjustment. This effect can last up to 36 months after the initial dose.
Balbuena
Lloyd
L
Institute of Cognitive Science, Carleton University, Ottawa, Ontario.
Mela
Mansfield
M
Wong
Stephen
S
Gu
Deqiang
D
Adelugba
Olajide
O
Tempier
Raymond
R
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D010054:Brief Psychiatric Rating Scale; D003024:Clozapine / Q000627:therapeutic use*; D057237:Criminals / Q000523:psychology*; D016832:Employment, Supported; D005260:Female; D005555:Forensic Psychiatry; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011329:Prisoners / Q000523:psychology*; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000523:psychology; D014754:Violence
D014150:Antipsychotic Agents; D003024:Clozapine