OBJECTIVES: To describe characteristics of adult Medicaid beneficiaries with schizophrenia initiated with Paliperidone Palmitate (PP) and assess the relationships between such characteristics and treatment continuity. METHODS: Adult Medicaid enrollees with schizophrenia, 30+ days of treatment with PP, and 6 months continuous enrollment prior to the first PP claim in 2009-2011 were identified in the MarketScan® Medicaid Multi-State Database. Exclusion criteria included dual eligible coverage, mental health carve-out, or a claim for Risperdal Consta at index.  Characteristics were compared between three groups created based on days continuous with PP (Group A: ≥151, B: 91-150, C: 31-90).  The first gap of 14+ days between the days covered by one claim and the date of the next claim was defined as the end of continuous therapy. Cox proportional hazards regression identified factors associated with PP treatment continuity over 6 months. RESULTS: A total of 725 patients comprised the sample, of which 339 (47%) were continuous with PP for ≥151 days. Overall, the average age for the sample was 39 years, 64% were male, 41% white. Pre-index characteristics for groups A vs C were significantly different with respect to the number of unique 3-digit ICD-9 diagnosis codes (mean/SD: 8.8/7.3 vs 10.8/8.9; p=0.004), number of unique psychiatric diagnostic categories (2.8/2.0 vs 3.5/2.2; p<0.001), number of unique antipsychotic agents (1.6/1.0 vs 1.8/1.1; p=0.028), diagnosed bipolar disorder (17% vs 27%; p=0.003), diagnosed depression (20% vs 30%; p=0.006), diagnosed alcohol abuse (9% vs 15%; p=0.029) and percent of patients with any psychiatric hospitalization (30% vs 42%; p=0.002). Cox proportional hazards regression models (saturated & stepwise) did not identify any factors significantly associated with treatment continuity.  CONCLUSIONS: Relative to patients continuous with PP therapy for longer than 151 days, patients with 31-90 days of continuous therapy had a more complex profile of mental health comorbidites and pre-index resource utilization.