Identification of Risk Factors to Predict the Occurrences of Relapses in Individuals with Schizophrenia Spectrum Disorder in Iran.

Omran Davarinejad,Farnaz Radmehr,Tahereh Mohammadi Majd,Mostafa Alikhani,Serge Brand,Payam Mohammadi,Tayebeh Motaei,Mehdi Moradinazar,Farzaneh Golmohammadi,Annette Brühl,Dena Sadeghi Bahmani

doi:10.3390/ijerph18020546

Abstract

Schizophrenia Spectrum Disorder (SSD) is a chronic psychiatric disorder with a modest treatment outcome. In addition, relapses are commonplace. Here, we sought to identify factors that predict relapse latency and frequency. To this end, we retrospectively analyzed data for individuals with SSD. Medical records of 401 individuals with SSD were analyzed (mean age: 25.51 years; 63.6% males) covering a five-year period. Univariate and multivariate Penalized Likelihood Models with Shared Log-Normal Frailty were used to determine the correlation between discharge time and relapse and to identify risk factors. A total of 683 relapses were observed in males, and 422 relapses in females. The Relapse Hazard Ratio (RHR) decreased with age (RHR = 0.99, CI: (0.98–0.998)) and with participants’ adherence to pharmacological treatment (HR = 0.71, CI: 0.58–0.86). In contrast, RHR increased with a history of suicide attempts (HR = 1.32, CI: 1.09–1.60), and a gradual compared to a sudden onset of disease (HR = 1.45, CI: 1.02–2.05). Gender was not predictive. Data indicate that preventive and therapeutic interventions may be particularly important for individuals who are younger at disease onset, have a history of suicide attempts, have experienced a gradual onset of disease, and have difficulties adhering to medication.

Highlights

The term schizophrenia spectrum disorder covers a broad range of different symptoms and not all individuals with Spectrum Disorder (SSD) display all the symptoms and not all symptoms are simultaneously present
The present study reviewed retrospectively the medical records of 401 individual with SSD over a period of about 60 months in order to identify factors predicting a relapse and the latency of relapses
The key findings of the present study were that over a period of 60 months, relapses were very common among individuals with SSD and that low adherence to medication, reported suicide attempts, a gradual onset of disease, and a younger age at disease onset all predicted a higher relapse ratio and a shorter relapse interval

Summary

Introduction

Even 100 years after Kreapelin’s seminal work on the phenomenon of dementia praecox, schizophrenia (schizophrenia spectrum disorder; SSD) remains enigmatic in regards to its multiform etiology, its symptomatology, its uncertain disease progress, the modest treatment outcomes, and the issue of comorbidities such as tobacco use disorder, obesity, and diabetes [1,2,3]. The term schizophrenia spectrum disorder covers a broad range of different symptoms and not all individuals with SSD display all the symptoms and not all symptoms are simultaneously present. Individuals with SSD show disorganization in formal thoughts and language, hallucinations, delusions, catatonic symptoms, dysfunctions in affect and mood, self-disorder, somatic symptoms, and neurocognitive.

Methods

Results

Discussion

Conclusion