Factors influencing relapse in patients with schizophrenia

• Published in: The Kerala journal of psychiatry Vol. 35; no. 2; p. 294
• Main Authors: P, Nabeel, TK, Saleem, AM, Ashfaq-U-Rahman
• Format: Journal Article
• Language: English
• Published: Indian Psychiatric Society (Kerala State Branch 31.01.2023
• Subjects: relapse, schizophrenia, risk factors
• ISSN: 0377-0699; 2395-1486
• DOI: 10.30834/KJP.35.2.2023.294

Introduction: Relapse is a major factor for disability and poor quality of life in patients with schizophrenia. Several factors contribute to the relapse of symptoms in schizophrenia. Studying the modifiable factors helps in planning relapse prevention strategies. Aims: The study aimed to assess the factors influencing relapse among patients with schizophrenia. The study focused on selected modifiable factors such as stressful life events, perceived stress, expressed emotion, drug compliance and perceived stigma. Methods: A comparative design was used for this study. Tools used for data collection included a semi-structured interview schedule, Life Change Index Scale, Perceived Stress Scale, Medication Adherence Rating Scale, Family Emotional Involvement and Criticism Scale and STIG-9 questionnaire. Purposive sampling technique was used. The sample consisted of two groups of patients with schizophrenia, 50 patients in relapse and another group of 50 patients in remission. Results: The two groups were comparable in terms of socio-demographic and clinical variables, except for history of substance use. The mean (Standard deviation) scores of stressful life events were higher for the relapse group [159.82 (53.87)] compared to controls [114.42 (30.98), p < 0.001]; so also, for perceived stress [12.40 (3.54) and 7.26 (2.93), p < 0.0001)]; expressed emotion [27.36 (6.19) and 17.24 (5.64), p < 0.001)]; poor drug compliance [3.78 (1.94) and 7.60 (1.67), p < 0.001], perceived stigma [14.46 (3.53) and 12.38 (3.28), p = 0.003]. Conclusion: Knowledge of factors that contribute to relapse in schizophrenia will help mental health service providers to improve the standards of care. Interventions in schizophrenia should specifically target relapse prevention and improved quality of life.