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¿Do we prescribe less clozapine to immigrant psychotic patients compared to non-immigrant psychotic patients?

Published online by Cambridge University Press:  01 September 2022

A. Trabsa*
Affiliation:
Hospital del Mar (Consorci Mar Parc de Salut de Barcelona), Psychiatry, Barcelona, Spain Parc de Salut Mar, Institut De Neuropsiquiatria I Addiccions, Barcelona, Spain
A. Mané
Affiliation:
Parc de Salut Mar, Institut De Neuropsiquiatria I Addiccions, Barcelona, Spain
A. Llimona González
Affiliation:
Hospital del Mar, Psychiatry, Barcelona, Spain
L. Vargas
Affiliation:
Hospital del Mar, Psychiatry, Barcelona, Spain
C. Muro
Affiliation:
Hospital del Mar (Consorci Mar Parc de Salut de Barcelona), Psychiatry, Barcelona, Spain
A. Moreno
Affiliation:
Parc de Salut Mar, Institut De Neuropsiquiatria I Addiccions, Barcelona, Spain
B. Amann
Affiliation:
Parc de Salut Mar, Institut De Neuropsiquiatria I Addiccions, Barcelona, Spain
V. Pérez-Solà
Affiliation:
Parc de Salut Mar, Institut De Neuropsiquiatria I Addiccions, Barcelona, Spain
*
*Corresponding author.

Abstract

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Introduction

Clozapine, the first atypical antipsychotic, is a highly effective medication for patients with treatment-resistant schizophrenia. Robust evidence describes important risk for psychosis in immigrant population(2). Despite this, some studies suggest that immigrant patients are less treated and misdiagnosed due to cultural barriers(3,4). Clozapine and Electroconvulsive therapy tend to be less prescribed in immigrants(3). However, few studies assess differences in clozapine prescription between immigrants and non-immigrant psychotic inpatients.

Objectives

To describe and compare clozapine prescription between psychotic patients and non-psychotic patients in a sample of Acute and Chronic inpatients.

Methods

Patients who have presented, according to DSM-V criteria, one or more non-affective psychotic episodes, were recruited in Acute and Chronic inpatients units leading to a total sample of 198 patients. Immigrant condition was defined as “a person who comes to live permanently in a foreign country”. Demographic characteristics of patients, clinical data and main pharmacological treatment were recorded through a questionnaire. Comparative analysis was performed with IBM SPSS Statistics using Chi-Square Test and t-Student test.

Results

From a total of 198patients clozapine was prescribed to 31(15,7%). From the total immigrant sample only 7,1% had prescribed clozapine compared to 24,2% from the locals(p<0.005). Significant differences in diagnosis associated to clozapine were found between both groups : Schizophrenia(57,1%immigrants, 57,1%locals), Schizoaffective disorder(14,3%immigrants, 41,7%locals) and Non specific psychosis (28,3%immigrants, 8,3%locals).

Conclusions

According to our results, immigrant psychotic inpatients receive less clozapine prescription compared to non-immigrant psychotic patients. There results should be considered to study barriers for clozapine prescription in this population and offer a treatment based in equality.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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