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Objective To evaluate differences in patient characteristics and real-world outcomes in two distinct high-risk cohorts of patients with serious mental illness (SMI). Methods Retrospective cross-sectional analysis using a national multi-payer claims database. Two SMI cohorts identified by a technical expert panel-patients recently discharged (RD) from an SMI-related hospitalization and early episode (EE) patients-were evaluated for antipsychotic medication adherence, healthcare utilization, and spending patterns. Results The analysis i