Table 1 Summary of variables included in the propensity score a
Type of patient characteristic | Covariates included |
|---|---|
General Covariates | |
Demographics | 49 Total Covariates including: Age (5-year categories), Sex, self-reported Race, Ethnicity, Marital Status, Income, Disability Status, Distance to VHA facility, Urban/Rural hospital location, and Year of Medication Start |
Psychiatric Covariates b | |
Presenting Diagnosis | 9 Variables, including Bipolar I, Bipolar II, Bipolar NOS, Major Depression, Depression NOS, Schizophrenia, Schizoaffective Disorder and Other Psychoses |
General Utilization | 74 Covariates, including Total VHA Mental Health (MH) Provider Visits x 6 time periods, Total MH hospitalizations x 2 time periods, and Total Diagnostic Interviews, Total Medication Management Visits, Total Individual Psychotherapy Visits, Total Group Psychotherapy Visits (all x 2 time periods), and Total Current MH Medications, Recently Discontinued MH medications, and Possibly Discontinued MH medications |
Comorbid Diagnoses | 46 Covariates including PTSD, Other Anxiety Disorders, Adjustment Disorders, Personality Disorders, Somatoform Disorders, Impulse Control Disorders, Sleep Disorders, Eating Disorders, Sexual Disorders, Delusional Disorder, ADHD, Development Disorders, Cognitive Disorder NOS, and Dissociative Disorder |
Comorbid Substance Abuse Diagnoses | 41 Covariates, including 4 Covariates (Abuse, Dependence, Remission from Abuse, and Remission from Dependence for each of the following: Alcohol, Amphetamines, Cocaine, Marijuana, Opioids, Sedatives, Other), with other covariates for Hallucinogen Abuse/Dependence/Remission, Combined Drug Dependence and Remission from Combined Drug Dependence, with and without opioids, Unspecified Dependence, and Alcohol intoxication and Alcohol or Drug psychoses |
Suicidal Behavior Diagnoses | 9 Covariates, designating if Suicidal Behavior was diagnosed during Nonmental Health hospitalizations, Mental Health hospitalizations, or as an Outpatient, x 3 time periods (0-30 days, 31-180 days, or 181-365 days prior to Lithium or Valproate initiation) |
Psychiatric Hospitalizations | 10 Covariates, including Covariates designating whether patient was an Inpatient on Start Date, discharged within the last 7 days, 8-30 days, 31-180 days, and 181-365 days, the type of latest hospitalization (Psychiatric, Substance Abuse, Residential/Day program, Domiciliary), and whether any hospitalizations in the last year involved an AMA (Against Medical Advice) discharge |
Specific Outpatient Utilization | 48 Covariates (all modeled as 0 visits, 1 visits, or 2+ visits): General Mental Health clinic, Psychiatry visits, Psychotherapy visits, Substance Use Disorder visit, Primary Care Mental Health clinic, Health Care for Homeless Veterans, and Substance Abuse and non-Substance Abuse visits, x 2 time periods (0-180 days and 181-365 days) |
Current Medications | 24 Covariates, including Olanzapine, Risperidone, Quetiapine, Ziprasidone, Aripiprazole, Clozapine, First Generation Antipsychotics, Other Mood Stabilizers, SSRIs, SNRIs, Bupropion, Mirtazapine, TCAs, MAOIs, Benzodiazepines, other Hypnotics, Stimulants, Substance Abuse treatments, and other medications |
Recent Medications | 24 covariates, designating prescriptions received in last 180 days for same medication categories as “Current Medications,” but for which the patients’ prescribed supply does not extend to the Lithium/Valproate start date |
Prior Treatment History | Prior treatment with Any Mood Stabilizer, Prior treatment with Lithium or Valproate |
Geographic Suicide Risk | 5 variables designating quintiles of Age-Adjusted State Suicide Rates (2000-2007) |
Nonpsychiatric Variables of Possible Particular Relevance to Suicide Risk b | |
Nonpsychiatric Diagnoses | 7 covariates, including any Acute Injury, any Fracture, Blood Vessel injury, Internal injuries, Open Wounds, Poisoning, Inhalation/Drowning/Asphyxiation injury |
Nonpsychiatric Utilization | 6 covariates, including Pain Clinic visits (0, 1, 2+) x 2 time periods |
Nonpsychiatric Medications | 4 variables, including current Opiate Pain Medicine, recent Opiate Pain Medicine, and 2 types of overdose antidotes |
Also Included b: | |
Numerous covariates designating Nonpsychiatric Diagnoses, Nonpsychiatric Hospitalizations, Nonpsychiatric VHA Utilization (both the general amount of Nonpsychiatric VHA care received and specific clinics attended and/or care received ), Nonpsychiatric Medications (current and recent), and Nonpsychiatric Diagnostic Tests. | |
3 covariates recording prior VHA pharmacy use (any prior use, use in the last 180 days, and use in the last 365 days) were also included to help balance the extensiveness of pharmacy records among recipients. | |