Jari Tiihonen´s research group

Real-world effectiveness of psychopharmacological treatment

Nowadays, most treatment guidelines are largely based on randomized controlled trials (RCTs), but also observational studies can give important contribution to evidence-based medicine. The patient populations in RCTs are highly selected, and follow-up periods are short and, therefore, the generalization of RCTs to real-world settings is questionable. Also, studying infrequent phenomena, such as death and suicide, is practically impossible in RCTs. We study the real-world effectiveness of psychopharmacological treatments of psychoses and depression by using nationwide hospital discharge, prescription and mortality registers.

We have shown that in the treatment of schizophrenia, use of antipsychotic is associated with decreased mortality compared with no use of antipsychotic, and clozapine is associated with lower mortality than other antipsychotics. We have also observed that benzodiazepine use is linked with increased mortality, whereas use of an antidepressant or several concomitant antipsychotics is not. In first episode patients, use of depot antipsychotic injections leads to decreased risk of rehospitalization.

We study also the etiology and neurobiology of schizophrenia and violent behavior with genetics and stem cell research.

Research Projects

• Studies on effectiveness on psychopharmacological treatments of schizophrenia and bipolar disorder
• Studies on neurobiology of schizophrenia, psychopathy, and antisocial personality

Selected publications

A nationwide cohort study of oral and depot antipsychotics after first hospitalization for schizophrenia.
Tiihonen J, Haukka J, Taylor M, Haddad PM, Patel MX, Korhonen P
Am J Psychiatry 2011 Jun;168(6):603-9

Naltrexone implant for the treatment of polydrug dependence: a randomized controlled trial.
Tiihonen J, Krupitsky E, Verbitskaya E, Blokhina E, Mamontova O, Föhr J, et al
Am J Psychiatry 2012 May;169(5):531-6

Polypharmacy with antipsychotics, antidepressants, or benzodiazepines and mortality in schizophrenia.
Tiihonen J, Suokas JT, Suvisaari JM, Haukka J, Korhonen P
Arch. Gen. Psychiatry 2012 May;69(5):476-83

Genetic background of extreme violent behavior.
Tiihonen J, Rautiainen MR, Ollila HM, Repo-Tiihonen E, Virkkunen M, Palotie A, et al
Mol. Psychiatry 2015 Jun;20(6):786-92

Mortality and Cumulative Exposure to Antipsychotics, Antidepressants, and Benzodiazepines in Patients With Schizophrenia: An Observational Follow-Up Study.
Tiihonen J, Mittendorfer-Rutz E, Torniainen M, Alexanderson K, Tanskanen A
Am J Psychiatry 2016 Jun;173(6):600-6

Pharmacological treatments and risk of readmission to hospital for unipolar depression in Finland: a nationwide cohort study.
Tiihonen J, Tanskanen A, Hoti F, Vattulainen P, Taipale H, Mehtälä J, et al
Lancet Psychiatry 2017 07;4(7):547-553

Real-World Effectiveness of Antipsychotic Treatments in a Nationwide Cohort of 29 823 Patients With Schizophrenia.
Tiihonen J, Mittendorfer-Rutz E, Majak M, Mehtälä J, Hoti F, Jedenius E, et al
JAMA Psychiatry 2017 07;74(7):686-693

Genome-Wide Association Studies of a Broad Spectrum of Antisocial Behavior.
Tielbeek JJ, Johansson A, Polderman TJC, Rautiainen MR, Jansen P, Taylor M, et al
JAMA Psychiatry 2017 12;74(12):1242-1250

Real-world Effectiveness of Pharmacologic Treatments for the Prevention of Rehospitalization in a Finnish Nationwide Cohort of Patients With Bipolar Disorder.
Lähteenvuo M, Tanskanen A, Taipale H, Hoti F, Vattulainen P, Vieta E, et al
JAMA Psychiatry 2018 04;75(4):347-355

20-Year Nationwide Follow-Up Study on Discontinuation of Antipsychotic Treatment in First-Episode Schizophrenia.
Tiihonen J, Tanskanen A, Taipale H
Am J Psychiatry 2018 08;175(8):765-773

Association of Antipsychotic Polypharmacy vs Monotherapy With Psychiatric Rehospitalization Among Adults With Schizophrenia.
Tiihonen J, Taipale H, Mehtälä J, Vattulainen P, Correll CU, Tanskanen A
JAMA Psychiatry 2019 May;76(5):499-507

Sex-specific transcriptional and proteomic signatures in schizophrenia.
Tiihonen J, Koskuvi M, Storvik M, Hyötyläinen I, Gao Y, Puttonen KA, et al
Nat Commun 2019 09;10(1):3933

Neurobiological roots of psychopathy.
Tiihonen J, Koskuvi M, Lähteenvuo M, Virtanen PLJ, Ojansuu I, Vaurio O, et al
Mol. Psychiatry 2019  Dec;25(12):3432-3441

20-year follow-up study of physical morbidity and mortality in relationship to antipsychotic treatment in a nationwide cohort of 62,250 patients with schizophrenia (FIN20).
Taipale H, Tanskanen A, Mehtälä J, Vattulainen P, Correll CU, Tiihonen J
World Psychiatry 2020 Feb;19(1):61-68

Antipsychotic use and risk of breast cancer in women with schizophrenia: a nationwide nested case-control study in Finland.
Taipale H, Solmi M, Lähteenvuo M, Tanskanen A, Correll CU, Tiihonen J.
Lancet Psychiatry. 2021 Oct;8(10):883-891. doi: 10.1016/S2215-0366(21)00241-8.

Representation and outcomes of individuals with schizophrenia seen in everyday practice who are ineligible for randomized clinical trials.
Taipale H, Schneider-Thoma J, Pinzón-Espinosa J, Radua J, Efthimiou O, Vinkers CH, Mittendorfer-Rutz E, Cardoner N, Pintor L, Tanskanen A, Tomlinson A, Fusar-Poli P, Cipriani A, Vieta E, Leucht S, Tiihonen J, Luykx JJ.
JAMA Psychiatry 2022 Mar 1;79(3):210-218, 2022. doi: 10.1001/jamapsychiatry.2021.3990.

Real-world effectiveness of antipsychotic doses for relapse prevention in patients with first-episode schizophrenia in Finland: a nationwide, register-based cohort study.
Taipale H, Tanskanen A, Correll CU, Tiihonen J.
Lancet Psychiatry 2022 Feb 16:S2215-0366(22)00015-3. doi: 10.1016/S2215-0366(22)00015-3. Online ahead of print.

Long-term treatment with clozapine and other antipsychotic drugs and the risk of haematological malignancies in people with schizophrenia: a nationwide case-control and cohort study in Finland.
Tiihonen J, Tanskanen A, Bell JS, Dawson JL, Kataja V, Taipale H.
Lancet Psychiatry. 2022 Mar 22:S2215-0366(22)00044-X. doi: 10.1016/S2215

Group members