Outcomes of patients with first-episode schizophrenia at one-year follow-up: Findings from the National Mental Health Registry in Malaysia

Abstract

Introduction This first outcome study for people with first-episode schizophrenia (FES) in Malaysia was based on data collected from the National Mental Health Registry (NMHR). The aim of the study was to assess the outcome of patients diagnosed with schizophrenia, one year after contact with mental health services; and to evaluate treatments as well as the utilization of medical and other services in the country. Methods All patients with FES registered in NMHR between 1 March 2004 and 28 February 2005 were included and 79 centers carried out outcome assessments. Socio-demographic and clinical data were collected and compared with the data in NMHR that was gathered one year ago. Descriptive statistic was used to analyze the data. Results Of 2604 registered patients with FES, only 37.7% had their outcomes successfully assessed. Among those assessed, 25.5% were lost to follow-up and 45.8% were followed-up in different centers. Only two patients committed suicide. Increases in weight gain and body mass index were major concerns. On a positive note, employability improved. Forty percent of the patients had their antipsychotics changed over the one-year period but about 20% of patients were on polytherapy at baseline and after one year. The use of anticholinergic medication dropped remarkably after the one-year treatment period. Discussion This study has shown that one of the great barriers in conducting a nationwide outcome assessment of FES patients was the high attrition rate. Nevertheless, these findings provided an important glimpse into the socio-demographic and clinical outcomes of the patients.