ArticleSchizophrenia bulletin2017
Adherence to Antipsychotic Medication and Criminal Recidivism in a Canadian Provincial Offender Population.
Article in Schizophrenia bulletin, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- A Systematic Review of Reviews of Correctional Mental Health Services Using the STAIR Framework.Frontiers in psychiatry · 2021Pooled it
- Exploring medication safety in prisons: a scoping review.BMJ open · 2026Article
- Prevalence and correlates of criminal victimization in Taiwanese outpatients with severe mental illness: a cross-sectional study.Frontiers in psychiatry · 2026Article
- Antipsychotic treatment adherence and motor vehicle crash among drivers with schizophrenia: a case-crossover study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Article
- Patterns and correlates of health service contact prior to serious offences by people with severe mental illness.The Australian and New Zealand journal of psychiatry · 2024Article
- Observational
- When do drugs trigger criminal behavior? a machine learning analysis of offenders and non-offenders with schizophrenia and comorbid substance use disorder.Frontiers in psychiatry · 2024Article
- Antipsychotic prescribing practices and their association with rehospitalization in a forensic psychiatric sample.Frontiers in psychiatry · 2024Article
- Post-discharge pharmacological treatment discontinuation of forensic psychiatric patients in Sweden.Frontiers in psychiatry · 2024Article
- [Association Between Medication Compliance and Various Risky Behaviors in Patients With Schizophrenia].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2023Article
- Recidivism among prisoners with severe mental disorders.Heliyon · 2023Article
- Medication Nonadherence and Risk of Violence to Others Among Patients With Schizophrenia in Western China.JAMA network open · 2023Article
- Impact of the early phase of the COVID-19 pandemic on the use of mental health services in South Korea: a nationwide, health insurance data-based study.Social psychiatry and psychiatric epidemiology · 2023Article
- Offenders and non-offenders with schizophrenia spectrum disorders: Do they really differ in known risk factors for aggression?Frontiers in psychiatry · 2023Article
- Offenders and non-offenders with schizophrenia spectrum disorders: the crime-preventive potential of sufficient embedment in the mental healthcare and support system.Frontiers in psychiatry · 2023Article
- High Risk, High Dose?-Pharmacotherapeutic Prescription Patterns of Offender and Non-Offender Patients with Schizophrenia Spectrum Disorder.Biomedicines · 2022Article
- Long-Acting Injectable Antipsychotics in a Prescription Claims Data Source: A Validation Study.Drugs - real world outcomes · 2022Article
- Second-Generation Long-Acting Injectable Antipsychotics and the Risk of Treatment Failure in a Population-Based Cohort.Frontiers in pharmacology · 2022Article
- Maintaining social capital in offenders with schizophrenia spectrum disorder-An explorative analysis of influential factors.Frontiers in psychiatry · 2022Article
- Multivariable modelling of factors associated with criminal convictions among people experiencing homelessness and serious mental illness: a multi-year study.Scientific reports · 2021Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 3 countries.
Funding
Abstract
Preliminary evidence suggests that adherence to antipsychotic medication reduces criminal recidivism among patients diagnosed with schizophrenia. However, existing studies operationalize antipsychotic adherence as a binary variable (usually using a threshold of ≥80%), which does not reflect the prevalence of suboptimal adherence in real-world settings. The purpose of the current analysis was to investigate the association between successive ordinal levels of antipsychotic adherence and criminal recidivism in a well-defined sample of offenders diagnosed with schizophrenia (n = 11462). Adherence was measured using the medication possession ratio (MPR) and analyzed as a time-dependent covariate in multivariable regression models. Data were drawn from linked, comprehensive diagnostic, pharmacy and justice system records, and individuals were followed for an average of 10 years. Adjusted rate ratios (ARR) and confidence intervals (CI) are reported. Overall mean MPR was 0.41. Increasing levels of antipsychotic adherence were not associated with progressively lower rates of offending. However, when compared to the reference group (MPR ≥ 80%) all lower adherence levels were significantly associated (P < .001) with increased risk of violent (ARR = 1.58; 95% CI = 1.46-1.71) and nonviolent (ARR = 1.41; 95% CI = 1.33-1.50) offenses. Significance was replicated in separate sensitivity analyses. Previously published studies reporting reductions in crime may have been influenced by antipsychotic adherence ≥80%. Binary operationalization of adherence is an inaccurate predictor of recidivism. Future research addressing functional outcomes of antipsychotic adherence should conceptualize adherence as an incremental independent variable.
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