OBJECTIVE: Examine the impact of clinical syndrome and type of antipsychotic medication on outpatient and inpatient utilization for participants in the U.S. SCAP. METHODS: Baseline data used to predict 1-year outpatient and inpatient utilization (n=806). Psychotherapy, clinic visits, rehabilitation treatment, day treatment and hospitalizations examined. Presence of antipsychotics coded for first generation (reference group), second generation, both first and second-generation, and no antipsychotic use. Logistic and negative binomial regressions using predicted values obtained through joint determination (SURE) of clinical/functional status conducted with demographic variables as controls. RESULTS: Persons with combination of first and second-generation antipsychotics exhibited higher likelihood (p<0.001) and greater number of psychotherapy visits (p<0.001), higher likelihood of day treatment (p=0.002) and shorter hospital length of stay (p=0.03). Persons prescribed only second-generation antipsychotics had higher likelihood (p=0.001) and greater number of psychotherapy visits (p=0.03), lower likelihood and number of clinic visits lower (p=0.05; p<0.001) and higher probability of rehabilitation (p=0.04). Depression (MADRS) and functionality (GAF) exhibited an inverse relationship to number of clinic visits. Higher functioning led to lower probability (p=0.001) of day treatment. Higher QLS scores associated with higher likelihood of day treatment (p<0.001) and fewer inpatient days of care (0.05). CONCLUSION: This analysis indicates that antipsychotic type impacts probability and number of outpatient services and days of inpatient care; impact however is mixed and warrants further investigation. Clinical and functional status impact utilization; results suggest a 'bimodal' utilization effect. Individuals with higher functioning levels may require fewer services to maintain community functioning; individuals with lower levels of functioning may not be well enough to participate in outpatient services. Findings suggest medication and functional status are significant determinants of inpatient and outpatient utilization; evaluation of these factors may lead to better clinical management and policy decision-making for persons with schizophrenia.