Predictors of relapse in Chinese schizophrenia patients: a prospective, multi-center study

Objective Relapse prevention is the main goal of maintenance treatment in schizophrenia. This study aimed to determine the rate and the socio-demographic and clinical predictors of relapse in Chinese schizophrenia patients following treatment of the acute phase of the illness. Methods In a multi-cen...

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Bibliographic Details
Published in:Social Psychiatry and Psychiatric Epidemiology 2011-12, Vol.46 (12), p.1325-1330
Main Authors: Xiang, Yu-Tao, Wang, Chuan-Yue, Weng, Yong-Zhen, Bo, Qi-Jing, Chiu, Helen F. K., Chan, Sandra S. M., Lee, Edwin H. M., Ungvari, Gabor S.
Format: Article
Language:English
Subjects:
Adult
Adult and adolescent clinical studies
Analysis
Antipsychotic Agents - administration & dosage
attitudes
Biological and medical sciences
Care and treatment
China
Diseases
Dose-Response Relationship, Drug
Drug dosages
Drugs
Electroconvulsive therapy
Epidemiology
Female
Health aspects
Humans
Longitudinal Studies
Maintenance
Male
Marital Status
Medical research
Medical sciences
Medication Adherence
Medicine
Medicine & Public Health
Medicine, Experimental
mental disorders
Mental health
Original Paper
Paranoia
Patient compliance
Prevention
Proportional Hazards Models
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology
Psychopathology. Psychiatry
Psychoses
Relapse
Risperidone - administration & dosage
Schizophrenia
Schizophrenia - classification
Schizophrenia - diagnosis
Schizophrenia - drug therapy
Secondary Prevention
Severity of Illness Index
Side effects
Social Adjustment
Sociodemographics
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Summary:Objective Relapse prevention is the main goal of maintenance treatment in schizophrenia. This study aimed to determine the rate and the socio-demographic and clinical predictors of relapse in Chinese schizophrenia patients following treatment of the acute phase of the illness. Methods In a multi-center, randomized, controlled, longitudinal study, 404 patients with schizophrenia who were clinically stabilized following an acute episode were randomly assigned to either the maintenance (i.e., initial optimal therapeutic doses continued throughout the study) or the dose-reduction group (i.e., initial optimal therapeutic doses continued for 4 or 26 weeks followed by a 50% dose reduction that was maintained until the end of the study). Participants were interviewed at entry using standardized assessment instruments, and followed up for 12–26 months. Results In univariate analyses, relapse was significantly associated with the membership of the dose-reduction group, poor medication adherence, and having a diagnosis of the paranoid type of schizophrenia. In Cox proportional-hazards regression analysis the membership of the dose-reduction group, poorer medication adherence, more severe drug-induced side effects and prominent paranoid symptoms independently predicted a higher risk of relapse. Conclusion The study confirmed the importance of maintenance medication in preventing relapse in Chinese schizophrenia patients underscoring the risk of relapse associated with lack of treatment adherence, severe side effects and the patients’ paranoid attitude. Socio-demographic characteristics were not associated with relapse in Chinese schizophrenia patients. Potential residual confounding caused by unmeasured variables should be fully considered in future studies.
ISSN:0933-7954
1433-9285
DOI:10.1007/s00127-010-0304-1