TY - JOUR
T1 - Antipsychotic treatment patterns and aggressive behavior among adolescents in residential facilities
AU - Miller, Leslie
AU - Riddle, Mark A.
AU - Pruitt, David
AU - Zachik, Al
AU - Dosreis, Susan
N1 - Funding Information:
We are grateful for the support of Dr. Brian Hepburn, Director, Maryland Mental Hygiene Administration (MHA); Gayle Jordan-Randolph, M.D., Jean Smith, M.D., Holly Sikoryak, M.D., David Horn, M.D. (Child Mental Health Institute for Children and Adolescents) (MHA); Eileen Hansen, LCSW, Ruth Anne McCormick, RN, C., DNSc, (University of Maryland); and Jane Walker (Maryland Coalition of Families for Children’s Mental Health). The authors are grateful to Sarah Davarya for her assistance with the data collection. This work was made possible through the financial support of the Maryland Mental Hygiene Administration (D Pruitt, M Riddle, PI) and T32 MH20033-10 (M Riddle, PI).
PY - 2013/1
Y1 - 2013/1
N2 - 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.
AB - 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.
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U2 - 10.1007/s11414-012-9314-y
DO - 10.1007/s11414-012-9314-y
M3 - Article
C2 - 23319375
AN - SCOPUS:84873744208
SN - 1094-3412
VL - 40
SP - 97
EP - 110
JO - Journal of Behavioral Health Services and Research
JF - Journal of Behavioral Health Services and Research
IS - 1
ER -