{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T15:42:22Z","timestamp":1784907742654,"version":"3.55.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T00:00:00Z","timestamp":1707436800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Most forensic psychiatric patients have chronic psychiatric disorders that require long-term pharmacological treatment even after discharge from care. However, the prevalence and correlates of post-discharge medication discontinuation in this patient group remain unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study was to investigate the prevalence and correlates of post-discharge discontinuation of pharmacological treatment in forensic psychiatric patients in Sweden.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data on individuals discharged from forensic psychiatric care between 2009 and 2018 (<jats:italic>n<\/jats:italic> = 1,142) with ongoing pharmacological treatment at the time of discharge (<jats:italic>n<\/jats:italic> = 856) were identified from the Swedish National Forensic Psychiatric Register. Cox regression models were used to estimate the association between patient characteristics and medication discontinuation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 856 individuals with pharmacological treatment at discharge, 488 (57%) discontinued treatment within 2 years of discharge. Factors associated with an increased risk of treatment discontinuation varied between different types of psychotropic medications: the most important correlate was comorbidity between psychosis and personality disorder. Higher age at discharge, longer length of stay, having a history of several psychiatric care episodes, having a trustee, having a limited guardian, and a residing in a supported living accommodation at the time of discharge were associated with a decreased rate of medication discontinuation. This applied for antipsychotics, antidepressants, antiepileptics, and any psychotropic medication, but not for psychostimulants or drugs used in addictive disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For many former forensic psychiatric patients, there are situational factors associated with medication discontinuation. This insight holds significance for professionals who are involved in pre-discharge planning within forensic psychiatric care and those who interact with this cohort of former patients post-discharge.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2024.1342722","type":"journal-article","created":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T04:55:57Z","timestamp":1707454557000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Post-discharge pharmacological treatment discontinuation of forensic psychiatric patients in Sweden"],"prefix":"10.3389","volume":"15","author":[{"given":"Ebba","family":"Noland","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suvi","family":"Virtanen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fia","family":"Kl\u00f6tz Logan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattias","family":"Strandh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,2,9]]},"reference":[{"key":"B1","volume-title":"Annual report 2020","year":"2020"},{"key":"B2","volume-title":"Psychotic Disorders","author":"Scott","year":"2019"},{"key":"B3","volume-title":"Compulsory Psychiatric Care Act","year":"1991"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.4103\/0022-3859.166514","article-title":"Incidence and factors associated with medication nonadherence in patients with mental illness: A cross-sectional study","volume":"61","author":"Lucca","year":"2015","journal-title":"J Postgrad Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1177\/1060028015593763","article-title":"Medication discontinuation in patients after discharge from a psychiatric hospital","volume":"49","author":"Abdullah-Koolmees","year":"2015","journal-title":"Ann Pharmacother"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa051688","article-title":"Effectiveness of antipsychotic drugs in patients with chronic schizophrenia","volume":"353","author":"Lieberman","year":"2005","journal-title":"New Engl J Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2017.01.036","article-title":"Factors associated with complete discontinuation of medication among patients with schizophrenia in the year after hospital discharge","volume":"250","author":"Zhou","year":"2017","journal-title":"Psychiatry Res"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-019-02707-z","article-title":"Adherence to psychotropic medication in completed suicide in Sweden 2006\u20132013: a forensic-toxicological matched case-control study","volume":"75","author":"Forsman","year":"2019","journal-title":"Eur J Clin Pharmacol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1097\/01.pra.0000344917.43780.77","article-title":"Medication adherence: A review of the literature and implications for clinical practice","volume":"15","author":"Julius","year":"2009","journal-title":"J Psychiatr Pract"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.161.4.692","article-title":"Adherence to treatment with antipsychotic medication and health care costs among medicaid beneficiaries with schizophrenia","volume":"161","author":"Gilmer","year":"2004","journal-title":"Am J Psychiatry"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-023-05428-x","article-title":"What happens after forensic psychiatric care? 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