Factors associated with relapse in schizophrenia

Aim. Early identification and prevention of relapse in patients with schizophrenia has significant therapeutic and socio- economic implications. The aim of this study was to determine the factors, if any, that may be associated with relapse in a group of patients in Johannesburg. Method. Patients were recruited from mental health outpatient clinics in a predominantly residential area during the period January 1995 - June 2005. They were included if a review of their records confirmed a diagnosis of schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders (4th edition) (DSM-IV); they had no other psychotic illness; and they were ≥ 18 years old. Patients were excluded if the diagnosis of schizophrenia had first been made in the preceding 6 months. Demographic and clinical characteristics of the patients were obtained from their case notes. Results. Of the 217 patients who were included in the study, 61.8% ( N =134) had a history of at least 1 relapse. There was no significant difference ( p >0.05) between those who relapsed and those who did not relapse in terms of gender, marital status or employment status. Approximately 46% ( N =61) of those who relapsed had co-morbid psychiatric disorders, compared with 10.8% ( N =9) in those who did not relapse ( p <0.0001), but there was no significant difference between the two groups when comparing the presence of co-morbid medical disorder ( p =0.348). Nearly half ( N =63) of patients who relapsed had a history of substance abuse ( p =0.0054); cannabis was significantly more abused (