Better treatment outcomes with aripiprazole long-acting injection in community and incarcerated patients with serious mental illness.

Importance: Aripiprazole, a partial D2 receptor agonist, is proposed to enhance prefrontal cortex (PFC) dopamine function, improving working memory and GABA transmission, which supports social functioning. Long-acting injectable (LAI) antipsychotics are known to improve patient adherence, leading to enhanced long-term effects on behavioral outcomes.

Objective: To evaluate whether aripiprazole LAI treatment improves general functioning, quality of life, and reduces hospitalizations in psychotic patients, both in community settings and within incarcerated populations.

Design Settings And Participants: The study included 55 patients, with 34 from the community and 21 incarcerated at a prison in Southeastern Greece (Neapolis). The World Health Organization Quality of Life Brief Version (WHOQOL-BREF) and the Clinical Global Impression-Severity (CGI-S) scale were used to assess outcomes. Comparisons were made between pre-treatment and post-treatment periods, with a minimum follow-up of six months.

Results: • Demographics: Community patients (70.6% male) included 44.1% with paranoid schizophrenia. Incarcerated patients (all male) had an F29.0 diagnosis, with 57.1% exhibiting Cluster B personality disorder and all reporting psychoactive substance use.• Hospitalizations: Community patients' hospitalizations decreased from 1.4 to 0.1 over six months (p=0.001). Incarcerated patients' hospitalizations dropped from 0.6 to 0.0 (p=0.066), with no significant intergroup difference (p=0.150).• CGI-S: Community patients' scores improved from 6.0 to 3.9 (p<0.001). Incarcerated patients' scores improved from 5.3 to 3.2 (p<0.001), with no significant difference between groups (p=0.814).• Quality of Life: Community patients' scores rose from 0.5 to 3.0 (p<0.001), while incarcerated patients' scores also increased significantly (p<0.001).

Conclusions: This study of 34 community and 21 incarcerated patients revealed significant demographic and medical history differences. Both groups experienced reduced hospitalizations and improvements in CGI-S scores and quality of life following aripiprazole LAI administration. Community patients showed a greater reduction in hospitalizations, while clinical and quality-of-life improvements were comparable across groups.