title: Antipsychotic treatment patterns and aggressive behavior among adolescents in residential facilities.
abstract: This study examined the association between acute aggressive behavior patterns of 145 adolescents in residential treatment facilities with use of and changes in antipsychotic medication for the chronic management of aggression. Seclusion/restraint (S/R) frequency over 12 months was used to categorize youth into none, low, moderate, and high S/R groups. Data were analyzed using longitudinal mixed effects logistic regression models that allowed for intra-subject variability over time. The high and moderate S/R groups were significantly more likely to receive antipsychotics, get higher doses, and have changes in medication compared with the none S/R group. Increases in antipsychotic dose were associated with a lower likelihood of changes in antipsychotic medication over time. Despite persistent antipsychotic use at higher doses, youth in the high and moderate S/R groups continued to be secluded/restrained frequently. The findings question the adequacy of these medications in managing aggressive behavior.
authors: Johns Hopkins University School of Medicine, Division of Child and Adolescent Psychiatry, Baltimore, MD 21224, USA. lmille84@jhmi.edu
authors: Leslie
authors: L
authors: Miller
authors: Mark A
authors: MA
authors: Riddle
authors: David
authors: D
authors: Pruitt
authors: Al
authors: A
authors: Zachik
authors: Susan
authors: S
authors: dosReis
mesh_terms: D000293:Adolescent; D000374:Aggression / Q000187:drug effects*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002648:Child; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D012112:Residential Facilities; D012114:Residential Treatment / Q000379:methods / Q000706:statistics & numerical data*; D012149:Restraint, Physical / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents