Lifetime relapse and its associated factors among people with schizophrenia spectrum disorders who are on follow up at Comprehensive Specialized Hospitals in Amhara region, Ethiopia: a cross-sectional study

Abstract

Background Relapse in psychiatric disorders is highly distressing that posed a huge burden to the patients, family, and society. It interrupts the process of recovery and may increase the risk of resistance to treatment. Relapse detection and taking preventive measures against its possible factors are crucial for a better prognosis. Objective To assess lifetime relapse and its associated factors among people with schizophrenia spectrum disorders who are on follow-up at Comprehensive Specialized Hospitals in Amhara region, Ethiopia. Method An institution-based cross-sectional study was conducted from July 13-August 13, at Comprehensive Specialized Hospitals in Amhara region, Ethiopia, 2020. Data were collected from 415 randomly selected participants using an interviewer administered questionnaire. Relapse was determined using participants’ medical records and a semi-structured questionnaire. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 25. Logistic regression analysis was done to identify the explanatory variables of relapse. Variables with P-value < 0.05 were considered significantly associated with relapse. Result The magnitude of lifetime relapse was 57.4% (95% CI = 53–62%). Relapse was significantly associated with comorbidity of another mental illness (AOR = 1.84, 95% CI = 1.06, 3.18), non-adherence to medication (AOR = 2.23, 95% CI = 1.22, 4.07), shorter duration on treatment (AOR = 1.71, 95% CI = 1.05, 2.81), and experiencing stressful life events (AOR = 2.42, CI = 1.2, 4.66). Conclusion In the current study, more than half of the participants had lifetime relapses. Comorbid mental illnesses, non-adherence, duration of treatment ≤ 5 years, and experiencing stressful life events were factors associated with relapse. This requires each stakeholder to give concern and work collaboratively on the respective factors that lead to relapse.

Results from PSIPROSPER: A multicenter retrospective study to analyze the impact of treatment with paliperidone palmitate 1-month on clinical outcomes and hospital resource utilization in adult patients with schizophrenia in Portugal

“…A qualitative study's systematic review on the experience of patients with LAIs showed that patients' education is essential, as well as a close therapeutic context with the attending physician, to increase patient adherence to such therapeutics (19). In the cases where this happens, the overall subjective experience of patients is deemed as very positive (9)(10)(11)18).…”

“…This condition is characterized by multiple relapses and psychotic episodes which have a significant detrimental impact on the life of patients and their families—impacting the performance in work and/or academic-related tasks ( 5 , 6 ) and quality of life ( 7 , 8 ). Relapses are common in schizophrenia, especially during the first years of treatment ( 9 – 11 ). Also, schizophrenia can pose a significant strain on public healthcare services, as a result of a high rate of hospitalizations and indirect costs ( 12 , 13 ).…”

Faktor Karakteristik dalam Kejadian Kekambuhan pada Pasien Skizofrenia

“…Menurut asumsi peneliti, usia dapat menjadi faktor utama kekambuhan, hal tersebut muncul karena perilaku kesehatan yang terbentuk seiring bertambahnya usia akan memengaruhi kepatuhan seseorang dalam pengobatan. Hal ini konsisten dengan hasil penelitian lain yang menunjukkan bahwa ketidakpatuhan pengobatan memiliki resiko lebih dari dua kali lipat mengalami kekambuhan dari pada yang patuh pada pengobatan (Moges, et al, 2021). Selain itu, pada usia dewasa kekambuhan dapat berulang apabila tidak didukung dengan support system terutama lingkungan keluarga, dimana kontrol minum obat memiliki pengaruh besar pada kepatuhan dan kekambuhan berulang.…”

The impact of caring for family members with mental illnesses on the caregiver: a scoping review

“…Of those who are hospitalized, ∼30-50% experience a relapse of symptoms within the first 6 months and 50-70% in the first 5 years after being discharged (Chang and Chou, 2015;Ali et al, 2017;Sadock et al, 2017). Comorbidity with other mental illness, non-adherence to medication, shorter duration on treatment and experiencing stressful life events as well as high disability score, and a single admission history are significant predictors of mental health relapse (Agenagnew and Kassaw, 2020;Moges et al, 2021). Patients with psychotic disorders who also experience common mental health disorders such as depression and anxiety are more likely to experience a relapse (Ali et al, 2017;Moges et al, 2021).…”

“…Comorbidity with other mental illness, non-adherence to medication, shorter duration on treatment and experiencing stressful life events as well as high disability score, and a single admission history are significant predictors of mental health relapse (Agenagnew and Kassaw, 2020;Moges et al, 2021). Patients with psychotic disorders who also experience common mental health disorders such as depression and anxiety are more likely to experience a relapse (Ali et al, 2017;Moges et al, 2021). Some novel approaches such as receiving low-intensity personalized advice via text-messages post-treatment (Malins et al, 2020) and specific forms of therapy such as Acceptance and Commitment Therapy (Østergaard, 2020), mind-body relaxation and therapies that allow the patient to develop healthy coping skills (Melemis, 2015) can be particularly beneficial in relapse prevention.…”