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Long-Acting Injectable Antipsychotics and Time to Readmission in Early Psychosis.
Caroline Wang1,2, Sean Lynch2,3, Chaden Noureddine1,2
1Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Journal of Child and Adolescent Psychopharmacology
|April 7, 2026
Summary
Long-acting injectable (LAI) antipsychotics were given to higher-risk young patients with early psychosis. Outcomes were similar to oral antipsychotics, suggesting LAIs may help manage elevated risk, but housing instability was a key factor in readmissions.
Area of Science:
- Psychiatry
- Pharmacology
- Public Health
Background:
- Long-acting injectable (LAI) antipsychotics are beneficial for psychotic disorders but their real-world use in early psychosis is not well understood.
- This study investigates LAI versus oral (PO) antipsychotics in young patients with early psychosis.
Purpose of the Study:
- To compare baseline characteristics, hospitalization details, and post-discharge outcomes for young patients with early psychosis treated with LAI versus PO antipsychotics.
- To determine if LAI treatment predicts psychiatric readmission within one year of discharge.
Main Methods:
- Retrospective chart review of 229 patients under 25 hospitalized for psychosis (2018-2022).
- Comparison of 144 LAI patients versus 85 PO patients on sociodemographic, clinical, and admission variables.
- Analysis of 1-year psychiatric readmission rates and time to readmission using Kaplan-Meier survival analysis and multivariable logistic regression.
Main Results:
- LAI patients were older with higher clinical/social risk (more prior hospitalizations, undomiciled status, suicide attempts) and longer stays.
- One-year readmission rates were similar (30.6% LAI vs. 24.7% PO).
- LAI treatment was not independently associated with readmission; undomiciled status showed a paradoxical association with lower readmission odds.
Conclusions:
- LAIs were used in higher-risk young patients with early psychosis but did not independently reduce 1-year readmission.
- Comparable outcomes suggest LAIs may mitigate risk, warranting prospective studies.
- Housing instability is a critical factor in readmission, highlighting the need for integrated interventions.
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