title: 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.
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.
authors.affiliation: Department of Psychiatry, Yokohama Camellia Hospital, Kanagawa, Japan; Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. Electronic address: michongjr@m.u-tokyo.ac.jp.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Nakamura
authors.forename: Hideo
authors.initials: H
authors.lastname: Yasunaga
authors.forename: Tadashi
authors.initials: T
authors.lastname: Haraguchi
authors.forename: Shuntaro
authors.initials: S
authors.lastname: Ando
authors.forename: Toru
authors.initials: T
authors.lastname: Sugihara
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Horiguchi
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ohe
authors.forename: Shinya
authors.initials: S
authors.lastname: Matsuda
authors.forename: Kiyohide
authors.initials: K
authors.lastname: Fushimi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D005260:Female; D006220:Haloperidol / Q000627:therapeutic use*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D006220:Haloperidol
keywords: Atypical antipsychotics; Haloperidol; Involuntary admission; Propensity score matching; Schizophrenia; Survival analysis