Abstract
BackgroundSchizophrenia is a recurrent, debilitating disease that is rarely curable. Rapid intervention after the first episode of schizophrenia has been shown to positively affect the prognosis. Unfortunately, basic data is scarce on first-episode schizophrenia in Korean patients making it difficult to create a comprehensive list of risk factors for relapse. This study aims to investigate the demographic characteristics and institutional factors of patients with first-episode schizophrenia in order to identify risk factors for relapse.MethodsData from the Health Insurance Review & Assessment Service (HIRA) was used for this study to represent the Korean patient population. To identify factors affecting relapse, we explored gender, age, geographic location, medical benefits, type of medical institution, type of medication used, medication adherence, and the severity of symptoms. Data analysis was performed using the Cox proportional hazard model.ResultsThe number of patients diagnosed with first-episode schizophrenia in Korea over a 2-year period was 4567 of which 1265 (27.7%) patients experienced a relapse during the observational period. Factors affecting relapse included age, type of medical institution, type of medication used, medication adherence, and type of treatment (inpatient or outpatient) after the initial diagnosis, which varied depending upon the severity of symptoms.ConclusionsIt was found that environmental and institutional factors as well as the type of medical treatment were crucial in determining whether patients with first-episode schizophrenia subsequently relapsed. The results of this study can be utilized as source material for directing therapeutic interventions and improving mental health policies in the future.
Highlights
Schizophrenia is a recurrent, debilitating disease that is rarely curable
After adjusting for the variables of gender, age, geographic location, medical benefits, type of medical institution, type of medication used, medication adherence, and the severity of symptoms, significant differences were found in the hazard ratio (HR) according to age, type of medical institution, type of medication used, medication adherence, and the severity of symptoms
After dividing patients into three groups based on medication adherence, the HR of the group with 0–50% adherence compared with the group with more than 80% adherence was 1.59, a significantly high result
Summary
Schizophrenia is a recurrent, debilitating disease that is rarely curable. Rapid intervention after the first episode of schizophrenia has been shown to positively affect the prognosis. Basic data is scarce on first-episode schizophrenia in Korean patients making it difficult to create a comprehensive list of risk factors for relapse. This study aims to investigate the demographic characteristics and institutional factors of patients with firstepisode schizophrenia in order to identify risk factors for relapse. One study reported that 41.0% of patients with schizophrenia were readmitted to a hospital within 1 year of discharge [10]. Another study indicated that 42.0% of patients with first-episode schizophrenia were readmitted to a hospital within 2 years [11]. A Korean study showed that 33.3–35.6% of patients with schizophrenia were re-hospitalized within 2 years [12, 13]. This study investigated demographic characteristics and institutional factors of patients with first-episode schizophrenia in order to identify risk factors for relapse. Data from the HIRA was used for this study to better represent the Korean patient population
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