Evidence map›Paper›PMID 41634664›Full record

ArticleBMC psychiatry2026

The prevalence of antipsychotic polypharmacy and its associations with violent behaviors among forensic psychiatry patients.

Mark Mohan Kaggwa, Joan Abaatyo, Praise Christi, Emma Lessard, John Bradford, Gary Andrew Chaimowitz, Andrew Toyin Olagunju

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Article in BMC psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Mark Mohan KaggwaDepartment of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda. kmarkmohan@gmail.com.
Joan AbaatyoDepartment of Psychiatry, King Ceasor University, Kampala, Uganda.
Praise ChristiMichael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
Emma LessardMichael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
John BradfordDepartment of Psychiatry and Behavioral Neurosciences, McMaster University, 100 West 5th, Hamilton, ON, L89 3K7, Canada.
Gary Andrew ChaimowitzDepartment of Psychiatry and Behavioral Neurosciences, McMaster University, 100 West 5th, Hamilton, ON, L89 3K7, Canada.
Andrew Toyin OlagunjuDepartment of Psychiatry and Behavioral Neurosciences, McMaster University, 100 West 5th, Hamilton, ON, L89 3K7, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEffective control of psychotic symptoms and behavioral problems is crucial in forensic psychiatric settings to enhance recovery and manage different risk concerns. While antipsychotic polypharmacy is commonly employed to ensure symptom control and risk mitigation, there is limited research on its burden and relationship with violent and aggressive behaviors in forensic psychiatric populations.

objectivesThis study aims to examine the prevalence of antipsychotic polypharmacy among forensic psychiatry patients in Ontario and assess its relationship with recent incidents of aggression and violence.

methodsWe conducted a retrospective analysis using a database prepared from data captured in annual reports submitted to the Ontario Review Board by 12 forensic programs in Canada. We utilized statistical analyses based on negative binomial regression to evaluate associations between antipsychotic polypharmacy and incidences of violence.

resultsAmong 1,104 patients in the databases, 37.8% (n = 417) were on antipsychotic polypharmacy. The most frequent combination was with Olanzapine or Quetiapine. Antipsychotic polypharmacy was more likely among individuals with increased incidents of physical violence to objects (adjusted incidence rate ratio [IRR]: 1.69; 95% Confidence Interval [CI]: 1.07–2.68; p = 0.025), self-harm (IRR: 3.30; 95% CI: 1.29–8.44; p = 0.013), and sexually inappropriate behavior (IRR: 2.43; 95% CI: 1.35–4.36; p = 0.003) and aggression (IRR: 1.57; 95% CI = 1.10–2.27; p = 0.014).

conclusionsAntipsychotic polypharmacy is prevalent among forensic psychiatry patients, and more likely among those with violent and aggressive behaviors. These findings underscore the need for innovative approaches and further research to inform clinical guidelines, thereby improving patient safety and treatment efficacy. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

AggressionAntipsychotic AgentsPolypharmacyViolenceAdultFemaleForensic PsychiatryHumansMaleMiddle AgedOntarioPrevalenceRetrospective StudiesSelf-Injurious BehaviorYoung AdultAntipsychotic AgentsAntipsychotic polypharmacyForensic psychiatrySelf-harmViolence

Identifiers

PMID41634664
PMCPMC12958582

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.