Psychotic relapse and associated factors among patients attending health services in Southwest Ethiopia: a cross-sectional study

Abstract

BackgroundPsychotic relapse leads to repeated hospitalization and negatively affects the clinical prognosis of the patients. Information on prevalence of relapse among patients with psychotic disorders in Ethiopian setting is scarce. This study aimed to assess the prevalence of relapse among patients with psychotic disorders attending services in Jimma University Specialized Hospital (JUSH).MethodsData were collected using interviewer administered questionnaire. We used medication adherence rating scale (MARS) to assess compliance to medication and abnormal involuntary movement scale (AIMS) to detect medication side effects. Logistic regression analysis was used to identify independent predictors of psychotic relapse. All variables with P-value <0.25 in the bivariate analyses were entered into multivariate logistic regression and variables with P-value < 0.05 in the final model were declared to be significantly associated with the outcome variable.ResultsThe prevalence of relapse among patients with psychotic disorder was 24.6 % (n = 95). Of this, 25.4 and 22.4 % were males and females respectively. The odds of developing psychotic relapse among patients living with family was 72 % lower than that of patients living alone (aOR = 0.28, 95 % CI = 0.08, 0.93). The odds of developing psychotic relapse among patients compliant to medication was 69 % lower than that of patients who were not compliant to medications (aOR = 0.31, 95 % CI = 0.12, 0.80). The odds of developing psychotic relapse among patients having high score on social support score was 48 % lower than that of patients who were compliant to medications (aOR = 0.52, 95 % CI = 0.28, 0.95). The odds of developing psychotic relapse among patients reporting to have sought religious support was 45 % lower than that of patients who have not sought religious support (aOR = 0.55, 95 % CI = 0.31, 0.96). On the other hand, the odds of developing psychotic relapse among participants who have experienced medication side effects was 1.83 times higher when compared to those who have never experienced medication side effects (aOR = 1.83, 95 % CI = 1.01, 3.31).ConclusionsThe high prevalence of relapse among patients with psychotic disorder needs special attention. Clinicians need to pay attention to medication side effects the patient faces. Intervening noncompliance to medication and appropriately managing medication side effects may help in preventing psychotic relapse that may result because of non-compliance. The provision of counseling, psycho education, psycho social support may help patients in improving compliance to medication and reducing psychotic relapse. Developing and strengthening community based rehabilitation services should be emphasized as part of mental healthcare services.

The Lifetime Prevalence and Factors Associated with Relapse Among Mentally Ill Patients at Jimma University Medical Center, Ethiopia: Cross Sectional Study

“…This study found that non-adherence increase relapse by 6.35 times compared to being adherent which was supported by the study done in the United States of America [36], London [37], India [38], Jordan [39], Jimma [33] and this similar result might be explained by adherence to medication is a pillar for the patient to control symptoms and prevent relapse. This study found that high disability score increases the chance of relapse by 3.72 times compared to having low disability score, and this study finding was supported by the world health organization mental illness prevention report [40], and this supporting evidence might be explained by patients current functionality status including their personal care and participation in a society which contributes for the stigma and self-esteem of patents associated with their current functionality and contribute for relapse.…”

“…This study found that lifetime prevalence of relapse70.2% which was higher than the study done in Johannesburg (61.8%) [4], London (53%) [31] and India (70%) [32] and this difference might due to the difference in a study participant, mental health service and literacy. Also, it is higher than the study done in Jimma (24.6%) [33], Addis Ababa (43%) [34] and Butajira (65.9%) [35] and this might be the difference in sample size, study design, and study setting as well as the diagnosis of patients were not inclusive.…”

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

“…The sample size was calculated using a single population proportion formula considering 43.3% relapse [ 19 ], 95% confidence interval, 5% margin of error, and 10% non-response rate. The final sample size was 415.…”

“…Another substance abuse was measured using the Drug Abuse Screening Test (DAST-10), which is a 10-item asking about abuse, dependence, and low-risk substance use in the last 12 months. This measure has been included in previous research conducted in Ethiopia [ 19 , 39 – 41 ]. DAST-10 has a very good internal consistency (α = 0.92), sensitivity, and specificity of 0.98 and 0.91 respectively [ 42 ].…”

“…Previous studies reported some of the modifiable risk factors associated with relapse, including poor treatment compliance, substance use, poor social support, delay in seeking care, stigma against mental illness, and unavailability of psychotropic drugs [ 19 , 20 ]. Identifying the factors associated with relapse will help to predict and prevent relapse in patient care.…”