PMH14: DEFICIT SYNDROME AND DRUG USE PATTERNS IN COMMUNITY-BASED SCHIZOPHRENIA CARE

Abstract

OBJECTIVE: To determine how deficit syndrome relates to patterns of antipsychotic drug use among persons with schizophrenia receiving community-based care. METHODS: Study participants were enrolled in the US Schizophrenia Care and Assessment Program (SCAP). Data were obtained from participants who completed the baseline and 6-month assessments and were using antipsychotic medications at baseline (n = 1019). Presence of deficit syndrome was assigned based on proxy methods using clinical data (Kirkpatrick B., et al., 1989). Antipsychotics were categorized as first-generation, second-generation, or other. Few participants received antipsychotics in the ?other? category (2%) and were not included in these analyses. Baseline characteristics and the presence of deficit syndrome were used to predict two outcomes: (1) the likelihood of receiving first-generation antipsychotics at the initial assessment, and (2) the likelihood of switching from one antipsychotic class to another between assessments. Covariates included demographic (gender, race, age, marital status, education, insurance), clinical (GAF, hallucinations/delusions, disorganization), medication adherence, and site variables. Logistic regression was applied. RESULTS: Deficit syndrome was not significantly related to use of a 1st-generation agent at baseline. A positive association was found for African Americans (.0004), lower hallucination/delusion scores (.02), and several site indicators (