Factors Associated with Relapse of Schizophrenia in Bangladesh

Md Kamrul Hassan,Md Julfikkar Alam,Md Inamul Islam,Abul Hossain Muhammad Kazi Mostofa Kamal

doi:10.11648/j.ajpn.20200803.14

Abstract

Context: In the face of increasing number of relapse cases of schizophrenia, sufficient work is not available in Bangladesh. Aims: To find out the common factors of relapse of schizophrenia in Bangladesh and to find out the relationship of relapse of schizophrenia with sociodemographic characteristics. Settings and Design: Cross-sectional descriptive study; Department of Psychiatry, Combined Military Hospital, Dhaka, National Institute of Mental Health (NIMH), Dhaka and Psychiatry department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Materials and Methods: Data from 50 relapse patients receiving treatment of schizophrenia were collected, from April 2018 to September 2018. Statistical Analysis Used: The data were processed and analyzed with the help of computer program SPSS (Statistical Package for Social Sciences) win version 16. Results: The mean age was 31.16 (±10.59) years ranging from 14 to 55 years. Majority of the respondents 70% (n=35) were under 35 years. 62% (n=31) of the respondents were male and 38% (n=19) were female. 96% (n=48) of the respondents were Muslims. 52% (n=26) of the respondents were married and 46% (n=23) were unmarried. 46% (n=23) were from rural background and 54% (n=27) of the respondents were from urban background. 40% (n=20) of the respondents were from lower class, 52% (n=26) were from middle class, and only 8% (n=4) were from higher class. 56% (n=28) of the respondents had perceived stressful life events and 44% (n=22) of the respondents had no such history. 52% (n=26) of the patients had experienced high expressed emotion and 48% (n=24) had low expressed emotion. Among the 50 relapsed schizophrenia patients, only 26% (n=13) had full compliance, 30% (n=15) had full noncompliance and rest had partial compliance. There was no significant relationship between educational status and medication compliance in the current study. The study revealed significant association with lower social class and presumptive stressful life events. Conclusions: This study highlighted the perceptions of schizophrenic patients and their caregivers about factors that influence relapse. It indicated that stressful life events, high expressed emotion, and non-compliance to medication had a role in relapse. This study provides information about socio-demographic and other related factors which can offer important guideline for future study. Adherence to antipsychotic medication, reducing high expressed emotion and stressful life events protect patients from relapse.

Highlights

Schizophrenia is a major mental health problem which is often difficult to manage and yet poorly understood
The result of various studies has contributed to the development of ‘relative’s expressed emotion’, which influence the relapse of schizophrenia
[4] Internationally, the factors commonly associated with relapse include poor adherence to treatment, substance abuse, co-morbid psychiatric illness, a co-morbid medical and/or surgical condition, stressful life events, and the treatment setting. [5] this study is designed to assess the factors associated with relapse of schizophrenia in Bangladesh

Summary

Introduction

Schizophrenia is a major mental health problem which is often difficult to manage and yet poorly understood. It afflicts a sizable population over the world. [2] Non-compliance rate with antipsychotic medication is. Md Kamrul Hassan et al.: Factors Associated with Relapse of Schizophrenia in Bangladesh high. The result of various studies has contributed to the development of ‘relative’s expressed emotion’, which influence the relapse of schizophrenia. It is often accompanied by relapse even while on treatment. [5] this study is designed to assess the factors associated with relapse of schizophrenia in Bangladesh It is often accompanied by relapse even while on treatment. [3] Relapse rates vary from 50% to 92% and are similar in developed and developing countries, despite the former having wellestablished mental health services. [4] Internationally, the factors commonly associated with relapse include poor adherence to treatment, substance abuse, co-morbid psychiatric illness, a co-morbid medical and/or surgical condition, stressful life events, and the treatment setting. [5] this study is designed to assess the factors associated with relapse of schizophrenia in Bangladesh

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