RESEARCH PROTOCOL
First-episode psychosis pharmacotherapy: an antipsychotics comparative effectiveness study
First-episode psychosis pharmacotherapy: an antipsychotics comparative effectiveness study
Version: 1.1.0
List of Abbreviations
| OHDSI | Observational Health Data Sciences and Informatics |
| DALY | Disability-Adjusted Life Years |
| FEP | First-episode psychosis |
| AP | Antipsychotic |
| SGA | Second-generation antipsychotic |
| FGA | First-generation antipsychotic |
| HR | Hazard ratio |
| OMOP | Observational Medical Outcomes Partnership |
| CDM | Common Data Model |
| HADES | Health Analytics Data-to-Evidence Suite |
| TAR | Time-at-Risk |
| PS | Propensity score |
| FEP2 | Firs-episode psychosis pharmacotherapy |
| ICD | International Classification of Diseases |
| PS | Propensity score |
| MDE | Minimum detectable effect |
Responsible Parties
Investigators
| Investigator | Institution/Affiliation |
|---|---|
| Aleksander Alexiayuk | Odysseus, an EPAM Company, Cambridge, MA, US |
| Dmitry Dymshyts | Johnson & Johnson, Observational Health Data Analytics, Titusville, FL, US |
| Polina Talapova | IT company SciForce, Kharkiv, Ukraine; Tufts Clinical and Translational Science Institute, Boston, MA, US |
| Maryna Skugarevskaya | Republican Scientific and Practical Center for Mental Health, Minsk, Belarus |
| Tatsiana Skuhareuskaya* | Odysseus, an EPAM Company, Cambridge, MA, US |
*Principal Investigator
Disclosures
This study is undertaken within Observational Health Data Sciences and Informatics (OHDSI), an open collaboration.
Abstract
Background and Significance: Schizophrenia is a severe neuropsychiatric disorder which often leads to a significant functional and cognitive impairment. Although its prevalence is relatively low [1-3], schizophrenia is one of the biggest causes of Disability-Adjusted Life Years (DALYs) worldwide [4]. The term ‘first-episode schizophrenia’ is often used interchangeably with the term ‘first-episode psychosis’ (FEP), since distinguishing former from the latter is a complex and often impossible clinical task, because clinical picture and further manifestations of the disorder may be multimodal and evolving. Studies show that interventions at the earliest stages of the disorder are important for ameliorating the course of illness through decreasing psychosis symptoms, improving functional outcomes, and reducing long-term disability [5, 6]. Treatment with antipsychotics (APs) is one of such interventions [7]. However, the choice of medication for treatment of FEP requires further investigation. Current clinical practice guidelines mention the heterogeneity of clinical trial designs and limited number of direct comparative studies as factors preventing from creating an evidence-based ranking of second-generation antipsychotics (SGAs) and first-generation antipsychotics (FGAs) [8].
Study Aims: This study aims to conduct a structured, cohort-based empirical emulation of target trials for pairwise comparisons framework for the effectiveness of several commonly used FGAs and SGAs when used in treating patients with first-episode psychoses.
Study Description: We will conduct a large-scale, systematic, observational study for each of the pairwise comparisons of 9 drugs of interest (Risperidone, Haloperidol, Aripiprazole, Brexpiprazole, Olanzapine, Quetiapine, Ziprazidone, Lurazidone, Paliperidone). This list includes the most common antipsychotic agents used for treatment of the first psychotic episode as per the results of OHDSI “Phenotype Phebruary 2025” initiative [9]. We will assess the hazard ratio (HR) of rehospitalizations with psychosis relapse as a proxy for drug effectiveness. The analysis will be executed across multiple Observational Medical Outcomes Partnership Common Data Model (OMOP CDM)-converted data sources, including claims and electronic health records (EHR) from both US and international OHDSI network partners. We acknowledge the potential for misclassification in outcome identification and will assess the robustness of the relapse outcome definition through sensitivity analyses and cohort diagnostics.
Population: Patients 18-40 years old experiencing a first-in-a-lifetime psychotic episode, and with no record of treatment non-adherence during the diagnosis period who are first-time users of a specific AP. For a diagnosis setting, we will require either a recorded inpatient visit or 2 subsequent visits within 30 days. We will exclude patients who had a diagnosis of an organic or drug-induced mental disorder to control for diagnosis recording differences across datasets.
Comparators: We defined drugs by a respective ingredient or, in the case of Quetiapine, of a dose of 100 mg or more. First exposure to one of the drugs on the list will be an indexing event, and we will censor follow-up on exposure to other antipsychotics, except when overlap occurs within the initial diagnostic confirmation window (30 days), to balance generalizability and data quality.
Outcomes: We will use rehospitalization with a diagnosis of a psychotic disorder as a proxy for drug effectiveness. Rehospitalization as an outcome encompasses both inherent drug effectiveness in relapse prevention as well as such factors as side effects influencing treatment adherence.
Design: Observational, active-comparator, new-user cohort study. This design will emulate target trials for each drug pair, applying large-scale propensity score modeling, empirical calibration, and meta-analysis across data sources using OHDSI’s Health Analytics Data-to-Evidence Suite (HADES) toolkit.
Timeframe: We will consider Time-at-Risk (TAR) window to start from the 31st day from cohort start (initial drug exposure) and last for 180 days. This lag is intended to avoid capturing acute switching due to early non-response and to focus on stable treatment effects.
Amendments and Updates
Version 1.0.0 - Initial protocol drafted for OHDSI review. Version 1.1.0 - Updated protocol with additions and corrections after OHDSI review. This section will be updated to reflect any protocol amendments, including changes to study population, outcome definitions, cohort logic, analysis strategy, or data partner eligibility. All updates will be versioned and documented in the study GitHub repository.
Milestones
The following milestones are planned for study execution:
Month 1: Finalize cohort definitions, concept sets, and negative controls in ATLAS. Month 2: Run DataDiagnostics across all eligible data sources. Month 3-5: Prepare, review and finalize for dissemination the protocol and study specification scripts. Month 6-7: Execute comparative effectiveness analyses using HADES (CohortMethod, EmpiricalCalibration). Month 8: Aggregate and meta-analyze results. Month 9: Disseminate results to OHDSI community and prepare manuscript.
Rationale and Background
Schizophrenia is a severe neuropsychiatric disorder which often leads to a significant functional and cognitive impairment. Symptoms of schizophrenia include psychotic symptoms such as delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior as well as negative symptoms (i.e., diminished emotional expression or avolition) [10]. Although the prevalence of schizophrenia is relatively low and estimates of the prevalence range between 0.33% to 0.75% [2, 3], schizophrenia is one of the biggest causes of DALYs worldwide [4]. Schizophrenia usually begins at young ages and is typically persistent; the disorder can be severe and disabling. The term “First-episode psychosis” refers to the first manifestation of psychotic symptoms in a person’s life and later such persons may be diagnosed with schizophrenia, bipolar disorder with psychotic features, schizoaffective disorder, and substance-induced psychosis [11]. Concept of FEP allows clinicians to focus on early intervention without prematurely diagnosing schizophrenia, which requires a longer observation period to confirm. The first five years after the onset of FEP have a disproportionate long-term impact on the patient’s psychosocial functioning and wellbeing [12, 13].Studies show that interventions at the earliest stages of the disorder are important for ameliorating the course of illness [14, 15]. Early interventions in FEP involve a combination of pharmacological and psychosocial treatments with the aim of preventing or limiting social, psychological and mental deterioration [16]. Treatment with antipsychotics is the main component of such interventions [17]. However, the choice of medication for treatment of FEP requires further investigation. Current clinical practice guidelines mention the heterogeneity of clinical trial designs and limited number of head-to-head comparisons as factors preventing from creating an evidence-based ranking of SGAs and FGAs [8]. It is usually recommended to choose antipsychotic for treatment of FEP on the basis of side effect profile by using ‘start law go slow’ approach [18]. Some guidelines recommended second generation antipsychotics as initial treatment of FEP without indicating the superiority of any of them in terms of efficacy [19-22]. The recommended duration of antipsychotic treatment after FEP remains unresolved, with some guidelines recommending antipsychotic discontinuation after 1 to 2 years of treatment [23]. Maintenance treatment with antipsychotics after FEP reduces rates of hospitalizations, improves life expectancy and improves functional outcomes [24-26] Measuring treatment effectiveness and outcomes and providing clinicians a clear roadmap for treatment remain challenging in the field of psychiatry. This is, among other things, related to low perceived severity of the disorders, perceived treatment ineffectiveness and stigma among patients [27]. Such complications to the research process result in difficulties when stratifying treatment options in the clinical guidelines, giving the practitioners guidance on the general principles, but leading to inconsistent treatment and care patterns across the globe [28-30]. This study seeks to address these gaps by leveraging large-scale, real-world data from multiple OMOP CDM-converted datasets across the OHDSI network, using validated phenotype definitions, reproducible analytic pipelines, and empirical calibration to estimate the relative effectiveness of commonly used APs for relapse prevention in first-episode psychosis.
Study Objectives
To inform clinical decisions and future policymaking, we will conduct an observational study comparing the effectiveness of antipsychotic agents - both first-generation (FGAs) and second-generation (SGAs) - in relapse prevention after the first-in-a-lifetime psychotic episode, using large-scale observational health data.
Research Methods
We will conduct a large-scale, systematic observational study to compare the hazard ratios of rehospitalization with a psychotic relapse among patients who were administered one of 9 APs of interest as a first-line treatment for FEP. We will conduct 36 head-to-head pairwise comparisons as indicated in a table below.| Comparators | Haloperidol | Risperidone | Aripiprazole | Brexpiprazole | Olanzapine | Quetiapine ≥ 100 mg/day and above | Ziprazidone | Lurazidone | Paliperidone |
|---|---|---|---|---|---|---|---|---|---|
| Haloperidol | |||||||||
| Risperidone | X | ||||||||
| Aripiprazole | X | X | |||||||
| Brexpiprazole | X | X | X | ||||||
| Olanzapine | X | X | X | X | |||||
| Quetiapine ≥ 100 mg/day and above | X | X | X | X | X | ||||
| Ziprazidone | X | X | X | X | X | X | |||
| Lurazidone | X | X | X | X | X | X | X | ||
| Paliperidone | X | X | X | X | X | X | X | X |
Propensity score (PS) modeling will be used to address confounding, including large-scale covariate adjustment via regularized regression. We will evaluate balance using standardized mean differences before and after adjustment. Both matching and stratification methods will be considered, with preference given to stratification unless matching yields better covariate balance. Hazard ratios (HR) will be estimated using Cox proportional hazards models within each data source. Results will be combined using random-effects meta-analysis, with leave-one-database-out sensitivity analyses to assess robustness. Negative control outcomes (see Appendix C) will be used to perform empirical calibration of effect estimates and p-values. To ensure reproducibility and consistency, all analyses will be performed using the OHDSI HADES suite.
Study Design
For each of the target-comparator pairs, we will employ a new-user, active-comparator cohort design, which is advocated as the primary design to be considered for comparative effectiveness and drug safety [31]. Cohort definitions will be developed using the OHDSI ATLAS tool and implemented with the CohortDiagnostics package to assess phenotype performance across data sources. We will be using first-in-a-lifetime drug exposure to one of the APs of interest as an indexing event for cohort entry. Here and below, when mentioning a diagnosis of a psychotic disorder for FEP, we will refer to a set of diagnoses that includes all the psychotic disorders and non-chronic affective disorders with psychotic symptoms, and specifically excludes organic and drug-induced psychoses. When assessing relapses, non-chronic affective disorders with psychotic symptoms will be excluded from the list. This will be done to allow for diagnosis variability in the case of FEP, since the first-in-a-lifetime diagnosis may present challenges to clinicians [11]. We will be limiting patients entering the cohort to those aged 18-40, who have been diagnosed with a psychotic disorder in an inpatient setting once or in an outpatient setting twice within 30 days prior to index date. We will exclude patients who had any other prior diagnoses of a psychotic disorder or any prior exposure to APs. To control for the effect disorder itself can have on treatment compliance, we will also exclude patients for whom non-compliance to treatment was recorded within the diagnosis period. To control for cases of polypharmacotherapy and prescription of several APs, we will be censoring on exposure to any other AP except the one used in an index event. We will be assessing outcomes within TAR of 180 days, starting on the 31st day after cohort start. This is intended to filter out the patients who were censored due to AP change too early, signifying a potential unreliable record. The overview of the cohort design choices is presented in Figure 1. More detailed cohort definitions along with the concept sets used are presented in Appendix A.
Figure 1: Overview of the cohort design choices
Data Sources
We will execute FEP2 as an OHDSI network study. All the Data Partners within OHDSI community are invited to participate. The transparency of the study is ensured by clear communication in the OHDSI Microsoft Teams environment and open access to the study repository on OHDSI Studies GitHub. We expect participating data sources to represent a mix of administrative claims and electronic health records, which will influence diagnosis granularity, medication exposure capture, and outcome ascertainment. We will document data source characteristics and handle heterogeneity in analysis accordingly.
Study Population
The study population will include all patients qualifying for the cohort definition described above. In addition, we require a minimum of 365 days of prior continuous observation. Since the study assesses the risk of a relapse, we will not be setting a clean window for prior outcome lookback.
Exposure Comparators
We will be using combined Exposure-Comparator cohorts for each of the 9 APs of interest. The cohort logic will follow the principles outlined in Figure 1, with detailed definitions outlined in Appendix A.
Outcomes
We will be using inpatient or ER visit with an accompanying diagnosis of a psychotic disorder (below - rehospitalization) as an outcome for the study. Outcome cohort definition is outlined in detail in Appendix B. We will be looking for outcomes happening within the Time-at-Risk window of 180 days starting on the 31st day after the index event. This is intended to (1) exclude from the analysis patients who were censored from the cohort early, signifying a potentially unreliable record; and (2) cover the crucial early period for psychosis relapse prevention [14, 15]. We acknowledge that using hospital-based diagnoses as outcomes may introduce outcome misclassification bias. We will explore this by evaluating the consistency of outcome definitions across data sources.
Analysis
We will be using several of the OHDSI Health Analytics Data-to-Evidence Suite (HADES) packages. First, each participating dataset will be examined using the CohortDiagnostics package [32]. It would allow for analyzing the datasets in relation to the cohort definitions, assessing sample sizes and potential differences emerging from dataset-specific features. At this step, the decision could be made of removing the dataset from the study if the results would suggest an inherent bias. Then, the study itself will be run using the CohortMethod package [33]. To control for the possible confounding factors, we will build a large-scale propensity score model for each of the parwise comparisons. We will perform all the analyses using matching and stratification by PS, giving preference to stratification if both models produce sufficient results. We will use Cox proportional hazards model to estimate HRs between the comparators in their respective pairs for each dataset. We will combine HRs from non-overlapping data sources using random effect meta-analysis model [34]. We will be using a list of negative control outcomes (outlined in Appendix C) to empirically calibrate the p-values [35, 36]. Then, we will assess if significant difference in HR exists between the comparators using the p-value of 0,05 as estimated based on the empirical null distribution. Lastly, the investigators will examine the study diagnostics results to check if the estimates can be considered unbiased. A summary table of PS diagnostics (population size, covariate balance, preference score overlap) and outcome model diagnostics (KM curves, Schoenfeld residuals for PH assumption) will be produced and reviewed.
Sample Size and Study Power
With each data source, we will execute all the analyses having 1000 eligible patients or more. The investigators will thoroughly assess the results of study diagnostics for generalizability and reliability. The diagnostics will include: minimum detectable risk ratios; preference score distributions; patient characteristics before and after adjusting by PS; negative control calibration plots; and Kaplan-Meier plots for HR. We will assess minimum detectable effect (MDE) sizes using observed event counts in each exposure group across the included data sources. Prior network studies and OHDSI data diagnostics will inform expected sample sizes for feasibility. CohortDiagnostics will provide early insight into power-related issues, and power diagnostics embedded in the HADES framework will be used to evaluate the adequacy of statistical power across pairwise comparisons.
Strengths and Limitations
The study’s strengths are based on its large-scale, real-world, multi-national observational data, federated execution across the OHDSI network, and use of validated, transparent cohort definitions developed with open-source OHDSI tools. We will be assessing the hazard ratio of an outcome crucial for further patient history, well-being and disease progression across a large number of data sources without deferring to patient- or physician-reported measures, which may blur the picture [27]. The study will be focusing on a knowledge gap admitted in several major clinical practice guidelines and publications [8, 19-22], paving the way for additional research for treatment effectiveness. Being an observational study, our investigation may be affected by unmeasured or misspecified confounders, including confounding by indication and differences in care-seeking behavior. To mitigate this, we will be using a large list of negative controls, representing exposure-outcome pairs with no known effect. Since we aim at estimating the effectiveness of single-drug therapies, the cohort design and censoring criteria may exclude otherwise eligible patients from the study. To control for the effect of that, in our cohort definition design we allow for a short window for drug change between the visits required as inclusion criteria; we also set the TAR start at day 31 to limit the number of patient whose records may be considered unreliable due to initial polypharmacotherapy or frequent drug switches as recorded in the data. Other limitations include potential misclassification of diagnoses, medication exposure, or outcome events; limited generalizability across populations due to data source heterogeneity; and inability to account for certain clinically relevant factors such as duration of untreated psychosis or socioeconomic context.
Protection of Human Subjects
FEP2 study will not involve human subjects research. The participating data partners will have access to human data collected during healthcare provision. The data will be de-identified within a data source. All analyses will be conducted on de-identified or pseudonymized patient-level data mapped to the OMOP CDM, in accordance with applicable data protection regulations. Under the U.S. HIPAA Privacy Rule, the study qualifies as non-human subjects research due to the use of de-identified data. In jurisdictions governed by the General Data Protection Regulation (GDPR), data processing will comply with the requirements for secondary use of pseudonymized health data. Each participating site is responsible for obtaining appropriate regulatory or institutional review, including exemption or approval from a local Institutional Review Board (IRB) or Ethics Committee, as required. No patient-level data will be shared across sites; only aggregate, non-identifiable results will be returned for meta-analysis.
Management and Reporting of Adverse Events and Adverse Reactions
This study is based on secondary use of de-identified EHRs mapped to the OMOP CDM, with no active subject follow-up. Therefore, individual-level adverse event reporting is not applicable. Instead, adverse events of interest - including extrapyramidal symptoms, metabolic syndrome, weight gain, cardiovascular events, and suicidality - may be explored as secondary or safety-related outcomes via standardized diagnosis codes and drug proxies. All such analyses will be conducted using pre-specified definitions or validated phenotype algorithms where available, in line with OHDSI best practices.
Plans for Disseminating and Communicating Study Results
Being conducted within the OHDSI community, our study follows the open-science paradigm. All the milestones will be reported in the OHDSI open communication channels. The cohort definitions used will be created at the publicly-available ATLAS demo platform [37]. The protocol and scripts used for creating study specifications will be published and updated in the corresponding OHDSI Studies GitHub repository [38]. The study progress and results will be presented to the OHDSI community during the weekly calls and at the Symposia; the results will be also presented to the larger audience of clinicians, researchers and policymakers at the annual professional congresses. In addition, study findings will be submitted for publication in peer-reviewed journals, and the finalized study package (including cohort definitions, code, diagnostics, and results) will be publicly released under an open-source license. Interactive diagnostics and results will be made accessible via the OHDSI Analysis Viewer or equivalent web-based interface.
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Appendix
Appendix A: Exposure Cohort Definitions
In the cohort definition below, the entry event ‘Antipsychotic’ drug exposure and the corresponding ‘APs wo …’ (where … stands for all AP except the one used in the index event) exclusion criteria and censoring event are as per table below.
Cohort Entry Events People with continuous observation of 365 days before event may enter the cohort when observing any of the following:
drug exposures of ‘Antipsychotic’*. Limit cohort entry events to the earliest event per person.
Inclusion Criteria 1. Age 18-40: Patients 18-40 years old Entry events with the following event criteria: who are between 18 and 40 years old.
Exclude noncompliance to treatment: Exclude patients with recorded noncompliance with treatment during the time period for entry event. Entry events having no observations of ‘[GDE2025] SCH Noncompliance with treatment’, starting between 30 days before and 0 days after cohort entry start date.
Exclude APs prior: Exclude antipsychotic exposure prior to entry event Entry events having no drug exposures of ‘[GDE2025] SCH All antipsychotics’, starting anytime up to 30 days before cohort entry start date.
Exclude SCs non-excludable otherwise: Exclude ICD10CM codes for dementia mapped to psychotic disorder Entry events having no condition occurrences of ‘[GDE2025] SCH First-episode psychosis’ (including ‘[GDE2025] SCH FEP source codes for exclusion’ source concepts), starting between 30 days before and 0 days after cohort entry start date.
1 IP or 2 OP visits: 1 IP or 2 OP visits with psychosis within 30 days, 30 days prior to drug exposure Entry events with any of the following criteria:
having at least 1 visit occurrence of ‘[GDE2025] SCH Inpatient Visit & ER’, starting between 30 days before and 0 days before cohort entry start date; having at least 1 condition occurrence of ‘[GDE2025] SCH First-episode psychosis’, starting between 0 days before and all days after ‘[GDE2025] SCH Inpatient Visit & ER’ start date and starting anytime on or before ‘[GDE2025] SCH Inpatient Visit & ER’ end date. having at least 2 condition occurrences of ‘[GDE2025] SCH First-episode psychosis’, starting between 30 days before and 0 days before cohort entry start date.
Exclude prior psychoses: No psychoses prior to the inclusion visit Entry events having no condition occurrences of ‘[PP25 FEP2] All psychotic disorders’, starting anytime up to 30 days before cohort entry start date.
No other APs on the first day: Exclude patients taking other APs on day 1 Entry events having no drug exposures of ‘[GDE2025] SCH APs wo …’**, starting between 0 days before and 0 days after cohort entry start date.
No other APs covering day 0: Excluding multiple drugs with long exposures Entry events having no drug exposures of ‘[GDE2025] SCH APs wo …’**, starting anytime prior to cohort entry start date and ending 1 days after cohort entry start date.
No organic psychotic conditions during the diagnosis period: Additional exclusion of organic and drug-induced psychoses Entry events having no condition occurrences of ‘[PP2025 FEP2] Organic psychoses’, starting between 60 days before and 0 days after cohort entry start date.
Cohort Exit The person exits the cohort at the end of continuous observation. The person exits the cohort when encountering any of the following events: 1. drug exposures of ‘[GDE2025] SCH APs wo …’**.
Cohort Eras Remaining events will be combined into cohort eras if they are within 0 days of each other.
Concept Sets used:| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 9201 | Inpatient Visit | IP | Visit | NO | YES | NO |
| 262 | Emergency Room and Inpatient Visit | ERIP | Visit | NO | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 9202 | Outpatient Visit | OP | Visit | NO | YES | NO |
| 9203 | Emergency Room Visit | ER | Visit | NO | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 4175212 | Patient noncompliance - general | 275936005 | SNOMED | NO | YES | NO |
| 4322482 | Noncompliance with treatment | 7058009 | SNOMED | NO | YES | NO |
| 37016872 | Noncompliance with antiretroviral medication regimen | 713017009 | SNOMED | YES | YES | NO |
| 4005175 | Noncompliance with dental treatment | 110479000 | SNOMED | YES | YES | NO |
| 4031367 | Noncompliance with dietary regimen | 129832003 | SNOMED | YES | YES | NO |
| 45767300 | Noncompliance with exercise regimen | 704662005 | SNOMED | YES | YES | NO |
| 4032522 | Noncompliance with fluid volume management | 129833008 | SNOMED | YES | YES | NO |
| 44810587 | Noncompliance with food fortification regimen | 898411000000109 | SNOMED | YES | YES | NO |
| 44811678 | Noncompliance with home made oral supplement regimen | 905791000000106 | SNOMED | YES | YES | NO |
| 45767299 | Noncompliance with immunization regimen | 704661003 | SNOMED | YES | YES | NO |
| 4308000 | Noncompliance with infection control regimen | 423678000 | SNOMED | YES | YES | NO |
| 44811675 | Noncompliance with oral nutritional supplement regimen | 905731000000105 | SNOMED | YES | YES | NO |
| 44807726 | Noncompliance with physiotherapy regimen | 818071000000107 | SNOMED | YES | YES | NO |
| 46270032 | Non-compliance with renal dialysis | 125141000119102 | SNOMED | YES | YES | NO |
| 763687 | Noncompliance with self-monitoring regimen | 444781000124106 | SNOMED | YES | YES | NO |
| 37016593 | Non-compliant with peritoneal dialysis prescription | 641000124109 | SNOMED | YES | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 766529 | haloperidol | 5093 | RxNorm | NO | YES | NO |
| 756018 | fluphenazine | 4496 | RxNorm | NO | YES | NO |
| 704984 | trifluoperazine | 10800 | RxNorm | NO | YES | NO |
| 794852 | chlorpromazine | 2403 | RxNorm | NO | YES | NO |
| 19057607 | amisulpride | 46303 | RxNorm | NO | YES | NO |
| 757688 | aripiprazole | 89013 | RxNorm | NO | YES | NO |
| 40164052 | asenapine | 784649 | RxNorm | NO | YES | NO |
| 46275300 | brexpiprazole | 1658314 | RxNorm | NO | YES | NO |
| 35603277 | cariprazine | 1667655 | RxNorm | NO | YES | NO |
| 735979 | risperidone | 35636 | RxNorm | NO | YES | NO |
| 785788 | olanzapine | 61381 | RxNorm | NO | YES | NO |
| 766814 | quetiapine | 51272 | RxNorm | NO | YES | NO |
| 712615 | ziprasidone | 115698 | RxNorm | NO | YES | NO |
| 792263 | loxapine | 6475 | RxNorm | NO | YES | NO |
| 709699 | molindone | 7019 | RxNorm | NO | YES | NO |
| 733008 | perphenazine | 8076 | RxNorm | NO | YES | NO |
| 745790 | pimozide | 8331 | RxNorm | NO | YES | NO |
| 700299 | thioridazine | 10502 | RxNorm | NO | YES | NO |
| 700465 | thiothixene | 10510 | RxNorm | NO | YES | NO |
| 19017241 | iloperidone | 73178 | RxNorm | NO | YES | NO |
| 40230761 | lurasidone | 1040028 | RxNorm | NO | YES | NO |
| 703244 | paliperidone | 679314 | RxNorm | NO | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped | X8 |
|---|---|---|---|---|---|---|---|
| 37402410 | Dementia in other diseases classified elsewhere, mild, with psychotic disturbance | F02.A2 | ICD10C | NO | NO | NO | |
| 37402418 | Dementia in other diseases classified elsewhere, moderate, with psychotic disturbance | F02.B2 | ICD10CM | NO | NO | NO | |
| 37402426 | Dementia in other diseases classified elsewhere, severe, with psychotic disturbance | F02.C2 | ICD10CM | NO | NO | NO | |
| 37402402 | Dementia in other diseases classified elsewhere, unspecified severity, with psychotic disturbance | F02.82 | ICD10CM | NO | NO | NO | |
| 37402439 | Unspecified dementia, mild, with psychotic disturbance | F03.A2 | ICD10CM | NO | NO | NO | |
| 37402447 | Unspecified dementia, moderate, with psychotic disturbance | F03.B2 | ICD10CM | NO | NO | NO | |
| 37402455 | Unspecified dementia, severe, with psychotic disturbance | F03.C2 | ICD10CM | NO | NO | NO | |
| 37402432 | Unspecified dementia, unspecified severity, with mood disturbance | F03.93 | ICD10CM | NO | NO | NO | |
| 37402431 | Unspecified dementia, unspecified severity, with psychotic disturbance | F03.92 | ICD10CM | NO | NO | NO | |
| 37402381 | Vascular dementia, mild, with psychotic disturbance | F01.A2 | ICD10CM | NO | NO | NO | |
| 37402391 | Vascular dementia, moderate, with anxiety | F01.B4 | ICD10CM | NO | NO | NO | |
| 37402389 | Vascular dementia, moderate, with psychotic disturbance | F01.B2 | ICD10CM | NO | NO | NO | |
| 37402397 | Vascular dementia, severe, with psychotic disturbance | F01.C2 | ICD10CM | NO | NO | NO | |
| 37402373 | Vascular dementia, unspecified severity, with psychotic disturbance | F01.52 | ICD10CM | NO | NO | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 436073 | Psychotic disorder | 69322001 | SNOMED | NO | YES | NO |
| 434900 | Drug-induced psychosis | 191483003 | SNOMED | YES | YES | NO |
| 4067987 | Opioid-induced psychotic disorder with delusions | 20385005 | SNOMED | YES | YES | NO |
| 4100247 | Organic psychotic condition | 191447007 | SNOMED | YES | YES | NO |
| 35622934 | Psychosis and severe depression co-occurrent and due to bipolar affective disorder | 765176007 | SNOMED | YES | YES | NO |
| 432590 | Delusional disorder | 48500005 | SNOMED | NO | YES | NO |
| 35610112 | Mania with psychotic features | 1089681000000108 | SNOMED | NO | YES | NO |
| 4250023 | Severe major depression with psychotic features | 73867007 | SNOMED | NO | YES | NO |
| 443559 | Drug-induced delusional disorder | 427975003 | SNOMED | YES | YES | NO |
| 375229 | Organic delusional disorder | 5510009 | SNOMED | YES | YES | NO |
| 4057246 | Postpartum psychosis | 18260003 | SNOMED | YES | YES | NO |
| 44782771 | Presenile dementia with delusions | 31081000119101 | SNOMED | YES | YES | NO |
| 380986 | Senile dementia with delusion | 371024007 | SNOMED | YES | YES | NO |
| 4154309 | Severe recurrent major depression with psychotic features | 28475009 | SNOMED | YES | YES | NO |
| 4141292 | Severe recurrent major depression with psychotic features, mood-congruent | 33078009 | SNOMED | YES | YES | NO |
| 4034842 | Severe recurrent major depression with psychotic features, mood-incongruent | 15193003 | SNOMED | YES | YES | NO |
| 434010 | Schizotypal personality disorder | 31027006 | SNOMED | NO | YES | NO |
| 36714473 | Psychosis co-occurrent and due to Parkinson’s disease | 719717006 | SNOMED | YES | YES | NO |
| 35609824 | Recurrent reactive depressive episodes, severe, with psychosis | 1086471000000103 | SNOMED | YES | YES | NO |
| 4322477 | Severe bipolar disorder with psychotic features, mood-congruent | 70546001 | SNOMED | YES | YES | NO |
| 35609901 | Late onset substance-induced psychosis | 1087461000000107 | SNOMED | YES | YES | NO |
| 3187953 | Postictal psychosis | 12920001000004106 | Nebraska Lexicon | YES | YES | NO |
| 45757162 | Psychotic disorder in mother complicating childbirth | 10760421000119102 | SNOMED | YES | YES | NO |
| 45757163 | Psychotic disorder in mother complicating pregnancy | 10760461000119108 | SNOMED | YES | YES | NO |
| 4030431 | Symbiotic infantile psychosis | 129602009 | SNOMED | YES | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 436073 | Psychotic disorder | 69322001 | SNOMED | NO | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 4100247 | Organic psychotic condition | 191447007 | SNOMED | NO | YES | NO |
- Antipsychotic concept sets:
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 735979 | risperidone | 35636 | RxNorm | NO | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 766529 | haloperidol | 5093 | RxNorm | NO | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 785788 | olanzapine | 61381 | RxNorm | NO | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 757688 | aripiprazole | 89013 | RxNorm | NO | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 46275300 | brexpiprazole | 1658314 | RxNorm | NO | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 712615 | ziprasidone | 115698 | RxNorm | NO | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 40230761 | lurasidone | 1040028 | RxNorm | NO | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 703244 | paliperidone | 679314 | RxNorm | NO | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 766843 | quetiapine 300 MG | 331545 | RxNorm | NO | YES | NO |
| 766844 | quetiapine 100 MG | 343199 | RxNorm | NO | YES | NO |
| 766848 | quetiapine 150 MG | 393456 | RxNorm | NO | YES | NO |
| 766849 | quetiapine 400 MG | 616482 | RxNorm | NO | YES | NO |
| 19095296 | quetiapine 200 MG | 343200 | RxNorm | NO | YES | NO |
| 35884652 | quetiapine 600 MG | OMOP5034049 | RxNorm Extension | NO | YES | NO |
** ‘AP wo …’ concept sets:
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 766529 | haloperidol | 5093 | RxNorm | NO | YES | NO |
| 756018 | fluphenazine | 4496 | RxNorm | NO | YES | NO |
| 704984 | trifluoperazine | 10800 | RxNorm | NO | YES | NO |
| 794852 | chlorpromazine | 2403 | RxNorm | NO | YES | NO |
| 19057607 | amisulpride | 46303 | RxNorm | NO | YES | NO |
| 757688 | aripiprazole | 89013 | RxNorm | NO | YES | NO |
| 40164052 | asenapine | 784649 | RxNorm | NO | YES | NO |
| 46275300 | brexpiprazole | 1658314 | RxNorm | NO | YES | NO |
| 35603277 | cariprazine | 1667655 | RxNorm | NO | YES | NO |
| 785788 | olanzapine | 61381 | RxNorm | NO | YES | NO |
| 766843 | quetiapine 300 MG | 331545 | RxNorm | NO | YES | NO |
| 766844 | quetiapine 100 MG | 343199 | RxNorm | NO | YES | NO |
| 766848 | quetiapine 150 MG | 393456 | RxNorm | NO | YES | NO |
| 766849 | quetiapine 400 MG | 616482 | RxNorm | NO | YES | NO |
| 19095296 | quetiapine 200 MG | 343200 | RxNorm | NO | YES | NO |
| 35884652 | quetiapine 600 MG | OMOP5034049 | RxNorm Extension | NO | YES | NO |
| 712615 | ziprasidone | 115698 | RxNorm | NO | YES | NO |
| 792263 | loxapine | 6475 | RxNorm | NO | YES | NO |
| 709699 | molindone | 7019 | RxNorm | NO | YES | NO |
| 733008 | perphenazine | 8076 | RxNorm | NO | YES | NO |
| 745790 | pimozide | 8331 | RxNorm | NO | YES | NO |
| 700299 | thioridazine | 10502 | RxNorm | NO | YES | NO |
| 700465 | thiothixene | 10510 | RxNorm | NO | YES | NO |
| 19017241 | iloperidone | 73178 | RxNorm | NO | YES | NO |
| 40230761 | lurasidone | 1040028 | RxNorm | NO | YES | NO |
| 703244 | paliperidone | 679314 | RxNorm | NO | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 756018 | fluphenazine | 4496 | RxNorm | NO | YES | NO |
| 704984 | trifluoperazine | 10800 | RxNorm | NO | YES | NO |
| 794852 | chlorpromazine | 2403 | RxNorm | NO | YES | NO |
| 19057607 | amisulpride | 46303 | RxNorm | NO | YES | NO |
| 757688 | aripiprazole | 89013 | RxNorm | NO | YES | NO |
| 40164052 | asenapine | 784649 | RxNorm | NO | YES | NO |
| 46275300 | brexpiprazole | 1658314 | RxNorm | NO | YES | NO |
| 35603277 | cariprazine | 1667655 | RxNorm | NO | YES | NO |
| 735979 | risperidone | 35636 | RxNorm | NO | YES | NO |
| 785788 | olanzapine | 61381 | RxNorm | NO | YES | NO |
| 766843 | quetiapine 300 MG | 331545 | RxNorm | NO | YES | NO |
| 766844 | quetiapine 100 MG | 343199 | RxNorm | NO | YES | NO |
| 766848 | quetiapine 150 MG | 393456 | RxNorm | NO | YES | NO |
| 766849 | quetiapine 400 MG | 616482 | RxNorm | NO | YES | NO |
| 19095296 | quetiapine 200 MG | 343200 | RxNorm | NO | YES | NO |
| 35884652 | quetiapine 600 MG | OMOP5034049 | RxNorm Extension | NO | YES | NO |
| 712615 | ziprasidone | 115698 | RxNorm | NO | YES | NO |
| 792263 | loxapine | 6475 | RxNorm | NO | YES | NO |
| 709699 | molindone | 7019 | RxNorm | NO | YES | NO |
| 733008 | perphenazine | 8076 | RxNorm | NO | YES | NO |
| 745790 | pimozide | 8331 | RxNorm | NO | YES | NO |
| 700299 | thioridazine | 10502 | RxNorm | NO | YES | NO |
| 700465 | thiothixene | 10510 | RxNorm | NO | YES | NO |
| 19017241 | iloperidone | 73178 | RxNorm | NO | YES | NO |
| 40230761 | lurasidone | 1040028 | RxNorm | NO | YES | NO |
| 703244 | paliperidone | 679314 | RxNorm | NO | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 766529 | haloperidol | 5093 | RxNorm | NO | YES | NO |
| 756018 | fluphenazine | 4496 | RxNorm | NO | YES | NO |
| 704984 | trifluoperazine | 10800 | RxNorm | NO | YES | NO |
| 794852 | chlorpromazine | 2403 | RxNorm | NO | YES | NO |
| 19057607 | amisulpride | 46303 | RxNorm | NO | YES | NO |
| 40164052 | asenapine | 784649 | RxNorm | NO | YES | NO |
| 46275300 | brexpiprazole | 1658314 | RxNorm | NO | YES | NO |
| 35603277 | cariprazine | 1667655 | RxNorm | NO | YES | NO |
| 735979 | risperidone | 35636 | RxNorm | NO | YES | NO |
| 785788 | olanzapine | 61381 | RxNorm | NO | YES | NO |
| 766843 | quetiapine 300 MG | 331545 | RxNorm | NO | YES | NO |
| 766844 | quetiapine 100 MG | 343199 | RxNorm | NO | YES | NO |
| 766848 | quetiapine 150 MG | 393456 | RxNorm | NO | YES | NO |
| 766849 | quetiapine 400 MG | 616482 | RxNorm | NO | YES | NO |
| 19095296 | quetiapine 200 MG | 343200 | RxNorm | NO | YES | NO |
| 35884652 | quetiapine 600 MG | OMOP5034049 | RxNorm Extension | NO | YES | NO |
| 712615 | ziprasidone | 115698 | RxNorm | NO | YES | NO |
| 792263 | loxapine | 6475 | RxNorm | NO | YES | NO |
| 709699 | molindone | 7019 | RxNorm | NO | YES | NO |
| 733008 | perphenazine | 8076 | RxNorm | NO | YES | NO |
| 745790 | pimozide | 8331 | RxNorm | NO | YES | NO |
| 700299 | thioridazine | 10502 | RxNorm | NO | YES | NO |
| 700465 | thiothixene | 10510 | RxNorm | NO | YES | NO |
| 19017241 | iloperidone | 73178 | RxNorm | NO | YES | NO |
| 40230761 | lurasidone | 1040028 | RxNorm | NO | YES | NO |
| 703244 | paliperidone | 679314 | RxNorm | NO | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 766529 | haloperidol | 5093 | RxNorm | NO | YES | NO |
| 756018 | fluphenazine | 4496 | RxNorm | NO | YES | NO |
| 704984 | trifluoperazine | 10800 | RxNorm | NO | YES | NO |
| 794852 | chlorpromazine | 2403 | RxNorm | NO | YES | NO |
| 19057607 | amisulpride | 46303 | RxNorm | NO | YES | NO |
| 757688 | aripiprazole | 89013 | RxNorm | NO | YES | NO |
| 40164052 | asenapine | 784649 | RxNorm | NO | YES | NO |
| 35603277 | cariprazine | 1667655 | RxNorm | NO | YES | NO |
| 735979 | risperidone | 35636 | RxNorm | NO | YES | NO |
| 785788 | olanzapine | 61381 | RxNorm | NO | YES | NO |
| 766843 | quetiapine 300 MG | 331545 | RxNorm | NO | YES | NO |
| 766844 | quetiapine 100 MG | 343199 | RxNorm | NO | YES | NO |
| 766848 | quetiapine 150 MG | 393456 | RxNorm | NO | YES | NO |
| 766849 | quetiapine 400 MG | 616482 | RxNorm | NO | YES | NO |
| 19095296 | quetiapine 200 MG | 343200 | RxNorm | NO | YES | NO |
| 35884652 | quetiapine 600 MG | OMOP5034049 | RxNorm Extension | NO | YES | NO |
| 712615 | ziprasidone | 115698 | RxNorm | NO | YES | NO |
| 792263 | loxapine | 6475 | RxNorm | NO | YES | NO |
| 709699 | molindone | 7019 | RxNorm | NO | YES | NO |
| 733008 | perphenazine | 8076 | RxNorm | NO | YES | NO |
| 745790 | pimozide | 8331 | RxNorm | NO | YES | NO |
| 700299 | thioridazine | 10502 | RxNorm | NO | YES | NO |
| 700465 | thiothixene | 10510 | RxNorm | NO | YES | NO |
| 19017241 | iloperidone | 73178 | RxNorm | NO | YES | NO |
| 40230761 | lurasidone | 1040028 | RxNorm | NO | YES | NO |
| 703244 | paliperidone | 679314 | RxNorm | NO | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 766529 | haloperidol | 5093 | RxNorm | NO | YES | NO |
| 756018 | fluphenazine | 4496 | RxNorm | NO | YES | NO |
| 704984 | trifluoperazine | 10800 | RxNorm | NO | YES | NO |
| 794852 | chlorpromazine | 2403 | RxNorm | NO | YES | NO |
| 19057607 | amisulpride | 46303 | RxNorm | NO | YES | NO |
| 757688 | aripiprazole | 89013 | RxNorm | NO | YES | NO |
| 40164052 | asenapine | 784649 | RxNorm | NO | YES | NO |
| 46275300 | brexpiprazole | 1658314 | RxNorm | NO | YES | NO |
| 35603277 | cariprazine | 1667655 | RxNorm | NO | YES | NO |
| 735979 | risperidone | 35636 | RxNorm | NO | YES | NO |
| 766843 | quetiapine 300 MG | 331545 | RxNorm | NO | YES | NO |
| 766844 | quetiapine 100 MG | 343199 | RxNorm | NO | YES | NO |
| 766848 | quetiapine 150 MG | 393456 | RxNorm | NO | YES | NO |
| 766849 | quetiapine 400 MG | 616482 | RxNorm | NO | YES | NO |
| 19095296 | quetiapine 200 MG | 343200 | RxNorm | NO | YES | NO |
| 35884652 | quetiapine 600 MG | OMOP5034049 | RxNorm Extension | NO | YES | NO |
| 712615 | ziprasidone | 115698 | RxNorm | NO | YES | NO |
| 792263 | loxapine | 6475 | RxNorm | NO | YES | NO |
| 709699 | molindone | 7019 | RxNorm | NO | YES | NO |
| 733008 | perphenazine | 8076 | RxNorm | NO | YES | NO |
| 745790 | pimozide | 8331 | RxNorm | NO | YES | NO |
| 700299 | thioridazine | 10502 | RxNorm | NO | YES | NO |
| 700465 | thiothixene | 10510 | RxNorm | NO | YES | NO |
| 19017241 | iloperidone | 73178 | RxNorm | NO | YES | NO |
| 40230761 | lurasidone | 1040028 | RxNorm | NO | YES | NO |
| 703244 | paliperidone | 679314 | RxNorm | NO | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 766529 | haloperidol | 5093 | RxNorm | NO | YES | NO |
| 756018 | fluphenazine | 4496 | RxNorm | NO | YES | NO |
| 704984 | trifluoperazine | 10800 | RxNorm | NO | YES | NO |
| 794852 | chlorpromazine | 2403 | RxNorm | NO | YES | NO |
| 19057607 | amisulpride | 46303 | RxNorm | NO | YES | NO |
| 757688 | aripiprazole | 89013 | RxNorm | NO | YES | NO |
| 40164052 | asenapine | 784649 | RxNorm | NO | YES | NO |
| 46275300 | brexpiprazole | 1658314 | RxNorm | NO | YES | NO |
| 35603277 | cariprazine | 1667655 | RxNorm | NO | YES | NO |
| 735979 | risperidone | 35636 | RxNorm | NO | YES | NO |
| 785788 | olanzapine | 61381 | RxNorm | NO | YES | NO |
| 766843 | quetiapine 300 MG | 331545 | RxNorm | NO | YES | NO |
| 766844 | quetiapine 100 MG | 343199 | RxNorm | NO | YES | NO |
| 766848 | quetiapine 150 MG | 393456 | RxNorm | NO | YES | NO |
| 766849 | quetiapine 400 MG | 616482 | RxNorm | NO | YES | NO |
| 19095296 | quetiapine 200 MG | 343200 | RxNorm | NO | YES | NO |
| 35884652 | quetiapine 600 MG | OMOP5034049 | RxNorm Extension | NO | YES | NO |
| 792263 | loxapine | 6475 | RxNorm | NO | YES | NO |
| 709699 | molindone | 7019 | RxNorm | NO | YES | NO |
| 733008 | perphenazine | 8076 | RxNorm | NO | YES | NO |
| 745790 | pimozide | 8331 | RxNorm | NO | YES | NO |
| 700299 | thioridazine | 10502 | RxNorm | NO | YES | NO |
| 700465 | thiothixene | 10510 | RxNorm | NO | YES | NO |
| 19017241 | iloperidone | 73178 | RxNorm | NO | YES | NO |
| 40230761 | lurasidone | 1040028 | RxNorm | NO | YES | NO |
| 703244 | paliperidone | 679314 | RxNorm | NO | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 766529 | haloperidol | 5093 | RxNorm | NO | YES | NO |
| 756018 | fluphenazine | 4496 | RxNorm | NO | YES | NO |
| 704984 | trifluoperazine | 10800 | RxNorm | NO | YES | NO |
| 794852 | chlorpromazine | 2403 | RxNorm | NO | YES | NO |
| 19057607 | amisulpride | 46303 | RxNorm | NO | YES | NO |
| 757688 | aripiprazole | 89013 | RxNorm | NO | YES | NO |
| 40164052 | asenapine | 784649 | RxNorm | NO | YES | NO |
| 46275300 | brexpiprazole | 1658314 | RxNorm | NO | YES | NO |
| 35603277 | cariprazine | 1667655 | RxNorm | NO | YES | NO |
| 735979 | risperidone | 35636 | RxNorm | NO | YES | NO |
| 785788 | olanzapine | 61381 | RxNorm | NO | YES | NO |
| 766843 | quetiapine 300 MG | 331545 | RxNorm | NO | YES | NO |
| 766844 | quetiapine 100 MG | 343199 | RxNorm | NO | YES | NO |
| 766848 | quetiapine 150 MG | 393456 | RxNorm | NO | YES | NO |
| 766849 | quetiapine 400 MG | 616482 | RxNorm | NO | YES | NO |
| 19095296 | quetiapine 200 MG | 343200 | RxNorm | NO | YES | NO |
| 35884652 | quetiapine 600 MG | OMOP5034049 | RxNorm Extension | NO | YES | NO |
| 712615 | ziprasidone | 115698 | RxNorm | NO | YES | NO |
| 792263 | loxapine | 6475 | RxNorm | NO | YES | NO |
| 709699 | molindone | 7019 | RxNorm | NO | YES | NO |
| 733008 | perphenazine | 8076 | RxNorm | NO | YES | NO |
| 745790 | pimozide | 8331 | RxNorm | NO | YES | NO |
| 700299 | thioridazine | 10502 | RxNorm | NO | YES | NO |
| 700465 | thiothixene | 10510 | RxNorm | NO | YES | NO |
| 19017241 | iloperidone | 73178 | RxNorm | NO | YES | NO |
| 703244 | paliperidone | 679314 | RxNorm | NO | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 766529 | haloperidol | 5093 | RxNorm | NO | YES | NO |
| 756018 | fluphenazine | 4496 | RxNorm | NO | YES | NO |
| 704984 | trifluoperazine | 10800 | RxNorm | NO | YES | NO |
| 794852 | chlorpromazine | 2403 | RxNorm | NO | YES | NO |
| 19057607 | amisulpride | 46303 | RxNorm | NO | YES | NO |
| 757688 | aripiprazole | 89013 | RxNorm | NO | YES | NO |
| 40164052 | asenapine | 784649 | RxNorm | NO | YES | NO |
| 46275300 | brexpiprazole | 1658314 | RxNorm | NO | YES | NO |
| 35603277 | cariprazine | 1667655 | RxNorm | NO | YES | NO |
| 735979 | risperidone | 35636 | RxNorm | NO | YES | NO |
| 785788 | olanzapine | 61381 | RxNorm | NO | YES | NO |
| 766843 | quetiapine 300 MG | 331545 | RxNorm | NO | YES | NO |
| 766844 | quetiapine 100 MG | 343199 | RxNorm | NO | YES | NO |
| 766848 | quetiapine 150 MG | 393456 | RxNorm | NO | YES | NO |
| 766849 | quetiapine 400 MG | 616482 | RxNorm | NO | YES | NO |
| 19095296 | quetiapine 200 MG | 343200 | RxNorm | NO | YES | NO |
| 35884652 | quetiapine 600 MG | OMOP5034049 | RxNorm Extension | NO | YES | NO |
| 712615 | ziprasidone | 115698 | RxNorm | NO | YES | NO |
| 792263 | loxapine | 6475 | RxNorm | NO | YES | NO |
| 709699 | molindone | 7019 | RxNorm | NO | YES | NO |
| 733008 | perphenazine | 8076 | RxNorm | NO | YES | NO |
| 745790 | pimozide | 8331 | RxNorm | NO | YES | NO |
| 700299 | thioridazine | 10502 | RxNorm | NO | YES | NO |
| 700465 | thiothixene | 10510 | RxNorm | NO | YES | NO |
| 19017241 | iloperidone | 73178 | RxNorm | NO | YES | NO |
| 40230761 | lurasidone | 1040028 | RxNorm | NO | YES | NO |
| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 766529 | haloperidol | 5093 | RxNorm | NO | YES | NO |
| 756018 | fluphenazine | 4496 | RxNorm | NO | YES | NO |
| 704984 | trifluoperazine | 10800 | RxNorm | NO | YES | NO |
| 794852 | chlorpromazine | 2403 | RxNorm | NO | YES | NO |
| 19057607 | amisulpride | 46303 | RxNorm | NO | YES | NO |
| 757688 | aripiprazole | 89013 | RxNorm | NO | YES | NO |
| 40164052 | asenapine | 784649 | RxNorm | NO | YES | NO |
| 46275300 | brexpiprazole | 1658314 | RxNorm | NO | YES | NO |
| 35603277 | cariprazine | 1667655 | RxNorm | NO | YES | NO |
| 735979 | risperidone | 35636 | RxNorm | NO | YES | NO |
| 785788 | olanzapine | 61381 | RxNorm | NO | YES | NO |
| 712615 | ziprasidone | 115698 | RxNorm | NO | YES | NO |
| 792263 | loxapine | 6475 | RxNorm | NO | YES | NO |
| 709699 | molindone | 7019 | RxNorm | NO | YES | NO |
| 733008 | perphenazine | 8076 | RxNorm | NO | YES | NO |
| 745790 | pimozide | 8331 | RxNorm | NO | YES | NO |
| 700299 | thioridazine | 10502 | RxNorm | NO | YES | NO |
| 700465 | thiothixene | 10510 | RxNorm | NO | YES | NO |
| 19017241 | iloperidone | 73178 | RxNorm | NO | YES | NO |
| 40230761 | lurasidone | 1040028 | RxNorm | NO | YES | NO |
| 703244 | paliperidone | 679314 | RxNorm | NO | YES | NO |
Appendix B: Outcome Cohort Definitions
Cohort Entry Events People may enter the cohort when observing any of the following:
visit occurrences of ‘[GDE2025] SCH Inpatient Visit & ER’; having at least 1 condition occurrence of ‘[GDE 2025] SCH Outcome psychosis relapse’, starting between 0 days before and all days after ‘[GDE2025] SCH Inpatient Visit & ER’ start date and starting anytime on or before ‘[GDE2025] SCH Inpatient Visit & ER’ end date. Limit cohort entry events to the earliest event per person.
Inclusion Criteria 1. Exclude SCs non-excludable otherwise: Exclude ICD10CM codes for dementia mapped to psychotic disorder Entry events having no condition occurrences of ‘[GDE2025] SCH First-episode psychosis’ (including ‘[GDE2025] SCH FEP source codes for exclusion’ source concepts), starting between 0 days before and all days after cohort entry start date and ending anytime on or before cohort entry end date.
Cohort Exit The person exits the cohort at the end of continuous observation.
Cohort Eras Remaining events will be combined into cohort eras if they are within 0 days of each other.
Concept Sets (other than already described in the ‘Exposure Cohort Definitions’ section):| Concept ID | Concept Name | Code | Vocabulary | Excluded | Descendants | Mapped |
|---|---|---|---|---|---|---|
| 436073 | Psychotic disorder | 69322001 | SNOMED | NO | YES | NO |
| 434900 | Drug-induced psychosis | 191483003 | SNOMED | YES | YES | NO |
| 4067987 | Opioid-induced psychotic disorder with delusions | 20385005 | SNOMED | YES | YES | NO |
| 4100247 | Organic psychotic condition | 191447007 | SNOMED | YES | YES | NO |
| 35622934 | Psychosis and severe depression co-occurrent and due to bipolar affective disorder | 765176007 | SNOMED | YES | YES | NO |
| 432590 | Delusional disorder | 48500005 | SNOMED | NO | YES | NO |
| 443559 | Drug-induced delusional disorder | 427975003 | SNOMED | YES | YES | NO |
| 375229 | Organic delusional disorder | 5510009 | SNOMED | YES | YES | NO |
| 4057246 | Postpartum psychosis | 18260003 | SNOMED | YES | YES | NO |
| 44782771 | Presenile dementia with delusions | 31081000119101 | SNOMED | YES | YES | NO |
| 380986 | Senile dementia with delusion | 371024007 | SNOMED | YES | YES | NO |
| 4154309 | Severe recurrent major depression with psychotic features | 28475009 | SNOMED | YES | YES | NO |
| 4141292 | Severe recurrent major depression with psychotic features, mood-congruent | 33078009 | SNOMED | YES | YES | NO |
| 4034842 | Severe recurrent major depression with psychotic features, mood-incongruent | 15193003 | SNOMED | YES | YES | NO |
| 434010 | Schizotypal personality disorder | 31027006 | SNOMED | NO | YES | NO |
| 36714473 | Psychosis co-occurrent and due to Parkinson’s disease | 719717006 | SNOMED | YES | YES | NO |
| 35609824 | Recurrent reactive depressive episodes, severe, with psychosis | 1086471000000103 | SNOMED | YES | YES | NO |
| 4322477 | Severe bipolar disorder with psychotic features, mood-congruent | 70546001 | SNOMED | YES | YES | NO |
| 35609901 | Late onset substance-induced psychosis | 1087461000000107 | SNOMED | YES | YES | NO |
| 3187953 | Postictal psychosis | 12920001000004106 | Nebraska Lexicon | YES | YES | NO |
| 45757162 | Psychotic disorder in mother complicating childbirth | 10760421000119102 | SNOMED | YES | YES | NO |
| 45757163 | Psychotic disorder in mother complicating pregnancy | 10760461000119108 | SNOMED | YES | YES | NO |
| 4030431 | Symbiotic infantile psychosis | 129602009 | SNOMED | YES | YES | NO |
Appendix C: Negative Control Concepts
| Outcome name | Outcome concept ID |
|---|---|
| Abnormal posture | 439935 |
| Abrasion and/or friction burn of multiple sites | 443585 |
| Absent kidney | 4092879 |
| Anomaly of jaw size | 45757682 |
| Benign paroxysmal positional vertigo | 81878 |
| Colostomy present | 4201390 |
| Complication of gastrostomy | 434675 |
| Developmental delay | 436077 |
| Deviated nasal septum | 377910 |
| Epidermoid cyst | 4170770 |
| Exhaustion due to excessive exertion | 437448 |
| Feces contents abnormal | 4092896 |
| Foreign body in ear | 374801 |
| Foreskin deficient | 4096540 |
| Galactosemia | 439788 |
| Genetic disorder carrier | 4168318 |
| Impacted cerumen | 374375 |
| Jellyfish poisoning | 4265896 |
| Lagophthalmos | 381021 |
| Lipid storage disease | 4027782 |
| Lymphangioma | 433997 |
| Marfan’s syndrome | 258540 |
| Mechanical complication of internal orthopedic device, implant AND/OR graft | 432798 |
| Nonspecific tuberculin test reaction | 40480893 |
| Physiological development failure | 437092 |
| Tooth loss | 433244 |
| Toxic effect of lead compound | 436876 |
| Tracheostomy present | 4201387 |
| Unsatisfactory tooth restoration | 45757285 |
| Abnormal pupil | 436409 |
| Abrasion and/or friction burn of trunk without infection | 199192 |
| Absence of breast | 4088290 |
| Acquired hallux valgus | 75911 |
| Acquired keratoderma | 137951 |
| Anal and rectal polyp | 73241 |
| Burn of forearm | 133655 |
| Calcaneal spur | 73560 |
| Changes in skin texture | 140842 |
| Chondromalacia of patella | 81378 |
| Complication due to Crohn’s disease | 46269889 |
| Contact dermatitis | 134438 |
| Contusion of knee | 78619 |
| Crohn’s disease | 201606 |
| Derangement of knee | 76786 |
| Disproportion of reconstructed breast | 45757370 |
| Effects of hunger | 433111 |
| Endometriosis | 433527 |
| Foreign body in orifice | 259995 |
| Ganglion cyst | 40481632 |
| Hammer toe | 433577 |
| Hereditary thrombophilia | 4231770 |
| Homocystinuria | 4012934 |
| Impingement syndrome of shoulder region | 4344500 |
| Ingrowing nail | 139099 |
| Injury of knee | 444132 |
| Kwashiorkor | 432593 |
| Late effect of contusion | 434203 |
| Late effect of motor vehicle accident | 438329 |
| Macular drusen | 4083487 |
| Melena | 4103703 |
| Noise effects on inner ear | 377572 |
| Non-toxic multinodular goiter | 136368 |
| Passing flatus | 4091513 |
| Postviral fatigue syndrome | 4202045 |
| Ptotic breast | 81634 |
| Regular astigmatism | 380706 |
| Senile hyperkeratosis | 141932 |
| Somatic dysfunction of lumbar region | 36713918 |
| Splinter of face without major open wound | 443172 |
| Sprain of ankle | 81151 |
| Strain of rotator cuff capsule | 72748 |
| Tear film insufficiency | 378427 |
| Verruca vulgaris | 140641 |
| Wrist joint pain | 4115367 |
| Wristdrop | 440193 |