Risk factors associated with relapse among schizophrenic patient at Ndera neuropsychiatric teaching hospital: A cross sectional study

Abstract

Introduction Schizophrenia is a psychiatric disorder that can be disabling, affecting around 24 million people worldwide or approximately 1 in 300 individuals. It is a chronic mental illness commonly characterized by hallucinations, delusions, disorganized speech and behavior. This mental health condition often leads to relapses, which can be attributed to factors such as non-compliance with antipsychotic medication, inadequate adherence to psychological interventions (such as missing medical appointments for follow-ups and prescription refills), lack of support from family members, and daily stressors. The objective of this study was to examine the risk factors associated with relapse among patients with schizophrenia who receive care at Ndera Neuropsychiatric Teaching Hospital.

Methods This cross-sectional study was conducted from June to August 2023, and a census technique was used to include the medical data of 133 out of 145 schizophrenia patients hospitalized in Ndera Neuropsychiatric Teaching Hospital in 2021 from January and December 2021. Twelve schizophrenic patients were excluded because they did not come back for follow-up after discharge. Each schizophrenic patient recruited was observed during 12 month in order to count the frequency of relapses and related risk factors over the course of a year. STATA was used to analyze the data. A logistic regression was performed to identify risk factors associated with relapse. P-values under 0.05 were considered to determine factors which were significantly associated to relapse

Results In total of one hundred thirty-three (133) medical records of patients with schizophrenia reviewed, eight five (85) were male and forty eight (48) were female. The mean age of participants was forty years old. The proportion of relapse among patients with schizophrenia admitted to the Ndera Neuropsychiatric Hospital was found to be high, at 77% (102/133). According to logistic regression, family support status (p Furthermore, non-adherence to psychological intervention was the only factor associated with relapse in multiple logistic regression (p<0.001, OR: 0.029, 95%, 0.005 - 0.0160). Patients who had strong adherence to psychological intervention were 2.9% (0.029) less likely to experience a relapse than those who had poor adherence.

Conclusion This study has statistically proved that non-adherence to psychological intervention (patients’ monthly visits) acts as risk factor of relapse in schizophrenia. This requires each stakeholder (patients' caregivers, health professionals, the Ministry of Health…) to express concern and work collaboratively on non-adherence to psychological intervention (patients' monthly visits) that leads to relapse.