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Research ArticleRegular Articles

Clozapine Reduces Self-Injurious Behavior in a State Prison Population

Theodore R. Zarzar, Terri L. Catlett, Maria G. O'Connell, Bryan H. Harrelson, Vincent P. Wilson, Genell N. Rashad, Dustin B. Morris, Joseph B. Williams, Susan S. Peebles and Brian B. Sheitman
Journal of the American Academy of Psychiatry and the Law Online March 2019, 47 (1) 61-67; DOI: https://doi.org/10.29158/JAAPL.003818-19
Theodore R. Zarzar
Dr. Zarzar is a Clinical Associate Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. Ms. Catlett is Deputy Director, Health Services, Dr. O'Connell is Director of Mental Health, Dr. Harrelson is Chief of Psychiatry, Dr. Wilson is a family physician, Ms. Rashad is a staff psychologist, and Dr. Morris is Psychological Program Manager at North Carolina Department of Public Safety, Raleigh, NC. Dr. Williams is a Clinical Assistant Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. Dr. Peebles is Medical Director, North Carolina Division of State Operated Healthcare Facilities, Raleigh, NC. Dr. Sheitman is a Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC.
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Terri L. Catlett
Dr. Zarzar is a Clinical Associate Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. Ms. Catlett is Deputy Director, Health Services, Dr. O'Connell is Director of Mental Health, Dr. Harrelson is Chief of Psychiatry, Dr. Wilson is a family physician, Ms. Rashad is a staff psychologist, and Dr. Morris is Psychological Program Manager at North Carolina Department of Public Safety, Raleigh, NC. Dr. Williams is a Clinical Assistant Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. Dr. Peebles is Medical Director, North Carolina Division of State Operated Healthcare Facilities, Raleigh, NC. Dr. Sheitman is a Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC.
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Maria G. O'Connell
Dr. Zarzar is a Clinical Associate Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. Ms. Catlett is Deputy Director, Health Services, Dr. O'Connell is Director of Mental Health, Dr. Harrelson is Chief of Psychiatry, Dr. Wilson is a family physician, Ms. Rashad is a staff psychologist, and Dr. Morris is Psychological Program Manager at North Carolina Department of Public Safety, Raleigh, NC. Dr. Williams is a Clinical Assistant Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. Dr. Peebles is Medical Director, North Carolina Division of State Operated Healthcare Facilities, Raleigh, NC. Dr. Sheitman is a Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC.
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Bryan H. Harrelson
Dr. Zarzar is a Clinical Associate Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. Ms. Catlett is Deputy Director, Health Services, Dr. O'Connell is Director of Mental Health, Dr. Harrelson is Chief of Psychiatry, Dr. Wilson is a family physician, Ms. Rashad is a staff psychologist, and Dr. Morris is Psychological Program Manager at North Carolina Department of Public Safety, Raleigh, NC. Dr. Williams is a Clinical Assistant Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. Dr. Peebles is Medical Director, North Carolina Division of State Operated Healthcare Facilities, Raleigh, NC. Dr. Sheitman is a Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC.
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Vincent P. Wilson
Dr. Zarzar is a Clinical Associate Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. Ms. Catlett is Deputy Director, Health Services, Dr. O'Connell is Director of Mental Health, Dr. Harrelson is Chief of Psychiatry, Dr. Wilson is a family physician, Ms. Rashad is a staff psychologist, and Dr. Morris is Psychological Program Manager at North Carolina Department of Public Safety, Raleigh, NC. Dr. Williams is a Clinical Assistant Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. Dr. Peebles is Medical Director, North Carolina Division of State Operated Healthcare Facilities, Raleigh, NC. Dr. Sheitman is a Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC.
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Genell N. Rashad
Dr. Zarzar is a Clinical Associate Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. Ms. Catlett is Deputy Director, Health Services, Dr. O'Connell is Director of Mental Health, Dr. Harrelson is Chief of Psychiatry, Dr. Wilson is a family physician, Ms. Rashad is a staff psychologist, and Dr. Morris is Psychological Program Manager at North Carolina Department of Public Safety, Raleigh, NC. Dr. Williams is a Clinical Assistant Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. Dr. Peebles is Medical Director, North Carolina Division of State Operated Healthcare Facilities, Raleigh, NC. Dr. Sheitman is a Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC.
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Dustin B. Morris
Dr. Zarzar is a Clinical Associate Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. Ms. Catlett is Deputy Director, Health Services, Dr. O'Connell is Director of Mental Health, Dr. Harrelson is Chief of Psychiatry, Dr. Wilson is a family physician, Ms. Rashad is a staff psychologist, and Dr. Morris is Psychological Program Manager at North Carolina Department of Public Safety, Raleigh, NC. Dr. Williams is a Clinical Assistant Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. Dr. Peebles is Medical Director, North Carolina Division of State Operated Healthcare Facilities, Raleigh, NC. Dr. Sheitman is a Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC.
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Joseph B. Williams
Dr. Zarzar is a Clinical Associate Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. Ms. Catlett is Deputy Director, Health Services, Dr. O'Connell is Director of Mental Health, Dr. Harrelson is Chief of Psychiatry, Dr. Wilson is a family physician, Ms. Rashad is a staff psychologist, and Dr. Morris is Psychological Program Manager at North Carolina Department of Public Safety, Raleigh, NC. Dr. Williams is a Clinical Assistant Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. Dr. Peebles is Medical Director, North Carolina Division of State Operated Healthcare Facilities, Raleigh, NC. Dr. Sheitman is a Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC.
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Susan S. Peebles
Dr. Zarzar is a Clinical Associate Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. Ms. Catlett is Deputy Director, Health Services, Dr. O'Connell is Director of Mental Health, Dr. Harrelson is Chief of Psychiatry, Dr. Wilson is a family physician, Ms. Rashad is a staff psychologist, and Dr. Morris is Psychological Program Manager at North Carolina Department of Public Safety, Raleigh, NC. Dr. Williams is a Clinical Assistant Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. Dr. Peebles is Medical Director, North Carolina Division of State Operated Healthcare Facilities, Raleigh, NC. Dr. Sheitman is a Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC.
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Brian B. Sheitman
Dr. Zarzar is a Clinical Associate Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. Ms. Catlett is Deputy Director, Health Services, Dr. O'Connell is Director of Mental Health, Dr. Harrelson is Chief of Psychiatry, Dr. Wilson is a family physician, Ms. Rashad is a staff psychologist, and Dr. Morris is Psychological Program Manager at North Carolina Department of Public Safety, Raleigh, NC. Dr. Williams is a Clinical Assistant Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. Dr. Peebles is Medical Director, North Carolina Division of State Operated Healthcare Facilities, Raleigh, NC. Dr. Sheitman is a Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC.
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    Figure 1.

    Number of disciplinary infractions for patients (n = 8) by quarter relative to clozapine initiation (6 months pre/posttreatment). *Quarter 1 begins the day following clozapine initiation.

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    Figure 2.

    Number of disciplinary infractions for patients (n = 3) by quarter relative to clozapine initiation (12 months pre/posttreatment). *Quarter 1 begins the day following clozapine initiation.

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    Table 1

    Medical Visits Related to Self-injurious Behavior and Infractions Among Clozapine-Treated Offenders

    PatientPre-treatment (6 months)Post-treatment (6 months)
    Urgent Care VisitsEmergency Room VisitsDisciplinary InfractionsAssaults on StaffUrgent Care VisitsEmergency Room VisitsDisciplinary InfractionsAssaults on Staff
    1353071032
    245116819933811
    311326401122
    4321311000
    559301200
    6551213400
    7182396121126
    840611000
    Totals94371973928116521
    % Change−70.2%−70.3%−67.0%−46.2%
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Journal of the American Academy of Psychiatry and the Law Online: 47 (1)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 47, Issue 1
1 Mar 2019
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Clozapine Reduces Self-Injurious Behavior in a State Prison Population
Theodore R. Zarzar, Terri L. Catlett, Maria G. O'Connell, Bryan H. Harrelson, Vincent P. Wilson, Genell N. Rashad, Dustin B. Morris, Joseph B. Williams, Susan S. Peebles, Brian B. Sheitman
Journal of the American Academy of Psychiatry and the Law Online Mar 2019, 47 (1) 61-67; DOI: 10.29158/JAAPL.003818-19

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Clozapine Reduces Self-Injurious Behavior in a State Prison Population
Theodore R. Zarzar, Terri L. Catlett, Maria G. O'Connell, Bryan H. Harrelson, Vincent P. Wilson, Genell N. Rashad, Dustin B. Morris, Joseph B. Williams, Susan S. Peebles, Brian B. Sheitman
Journal of the American Academy of Psychiatry and the Law Online Mar 2019, 47 (1) 61-67; DOI: 10.29158/JAAPL.003818-19
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