Course and predictors of disability in Thai patients with schizophrenia: A 2-year, multi-center, prospective, observational study.

Abstract

This 2-year, multi-center, prospective, observational study aimed to describe the course and examine baseline characteristics for predicting disability in Thai patients with schizophrenia. Participants were patients with schizophrenia aged 18-65 years receiving treatment in five tertiary hospitals. Disability was defined by a score of 10 or more of the 12-item World Health Organization Disability Assessment Schedule, version 2.0 (12-item WHODAS 2.0). Other data being collected included socio-demographic data, course of illness, antipsychotics, antipsychotic drug attitudes, behavioral/psychiatric symptoms, alcohol use, social supports, and quality of life at five visits, including weeks 0 (baseline), 24, 48, 72, and 96. Of the 158 enrolled patients, we analyzed the data of 119 participants who were reassessed at least once during the follow-up. These 119 participants (70% male) had median age and age at psychotic onset of 38 and 22 years, respectively. Disability was found in 43 (36.1%) participants at baseline and 72 (64.7%) participants at week 96. The median [interquartile ranges] WHODAS scores at five time points were 6 [3-12], 9 [4-13], 10 [6-10], 10 [4-10], and 10 [6-10], respectively (p<0.001). The multivariate logistic regression analysis revealed that duration of psychosis (adjusted odds ratio = 1.08, 95%CI = 1.04 - 1.14, p=0.001) and depression (adjusted odds ratio = 3.54, 95%CI = 1.14 - 11.06, p=0.029) at baseline predicted 2-year disability. Thai patients with schizophrenia had an increase in disability over a 2-year follow-up period. Duration of psychosis and depression were predictors of disability in these patients.