Objective: This study evaluated rates of all-cause mortality and self-harm in association with clozapine treatment in individuals with treatment-resistant schizophrenia.
Method: A population-based cohort of 2,370 individuals with treatment-resistant schizophrenia after Jan. 1, 1996, was followed until death, first episode of self-harm, emigration, or June 1, 2013. Time to all-cause death and time to first episode of self-harm were analyzed in Cox regression models with time-varying treatment, adjusted for clinical and sociodemographic covariates.
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The participant will analyze commonly used antipsychotic treatment strategies and their overall and temporal effects on mortality and self-harm.
This program is designed for all psychiatrists in clinical practice, residents in Graduate Medical Education programs, medical students interested in psychiatry, and other physicians who wish to advance their current knowledge of clinical medicine.
Duration: 1 hour
Begin Date: October 1, 2017
End Date: September 30, 2019
In order to earn CME credit, subscribers should read through the material presented in the article. After reading the article, complete the quiz and submit your evaluation and study hours (up to 1 AMA PRA Category 1 Credit™). A score of 60% or higher is required to receive credit.
The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The APA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Title: Mortality and Self-Harm in Association With Clozapine in Treatment-Resistant Schizophrenia
Authors: Theresa Wimberley, Ph.D., James H. MacCabe, Ph.D., Thomas M. Laursen, Ph.D., Holger J. Sørensen, Ph.D., Aske Astrup, M.Sc., Henriette T. Horsdal, Ph.D., Christiane Gasse, Ph.D., Henrik Støvring, Ph.D.
Affiliations: From the National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus BSS, Aarhus University, Aarhus, Denmark (T.W., T.M.L., A.A., H.T.H., C.G.); the Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus and Copenhagen, Denmark (T.W., T.M.L., A.A., H.T.H., C.G.); the Centre for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark (T.W., T.M.L., A.A., H.T.H., C.G.); the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London (J.H.M.C.); the Research Unit, Mental Health Centre Copenhagen, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark (H.J.S.); and the Department of Public Health, Biostatistics, Aarhus University, Aarhus, Denmark (H.S.).
Disclosures: Dr. Gasse has received an unrestricted research grant from Eli Lilly and was in a research collaboration with LA-SER Analytica. The other authors report no financial relationships with commercial interests.
Discussion of unapproved or investigational use of products*: No.
*APA policy requires disclosure by CME authors of unapproved or investigational use of products discussed in CME programs. Off-label use of medications by individual physicians is permitted and common. Decisions about off-label use can be guided by scientific literature and clinical experience.
Robert Freedman, M.D. (Editor-in-Chief, AJP); Susan K. Schultz, M.D. (Deputy Editor, AJP); Michael D. Roy (Editorial Director, AJP); Michael A. Pogachar (Online Content Manager, Journals).
Dr. Schultz has received research support from the Alzheimer’s Disease Cooperative Study for projects conducted in partnership with Toyama Chemical Company and in partnership with Eli Lilly and Company. Dr. Freedman, Mr. Roy, and Mr. Pogachar report no financial relationships with commercial interests.
Optimal System Configuration:
- Flash Player: Adobe Flash Player 10.1+
- Browser: Firefox 3+, Internet Explorer 8.0+, Safari 4.0+, or Google Chrome 7.0+
- Operating System: Windows XP+ or Mac OS X 10.4+
- Internet Connection: 1 Mbps or higher
- Screen Resolution: 1024 x 768 pixels.
- Windows PC:500-MHz Pentium II; Windows XP or higher; 128 MB RAM; Video Card at least 64MB of video memory; Sound Card at least 16-bit; Macromedia Flash Player 10 or higher, audio playback with speakers for programs with video content; Firefox 1.1+, Internet Explorer 7.0+, Safari 1.0+, Google Chrome, or Opera
- Macintosh: Mac OS X 10.3 or higher with latest updates installed; 1.83MHz Intel Core Duo or faster; RAM: 128MB or more; Video Card: at least 64MB of video memory; Sound Card: at least 16-bit
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