A Cross-sectional Study of Factors Predicting Relapse in People with Schizophrenia
Keywords:
Predicting factors, Family support, Medication adherence, Relapse, SchizophreniaAbstract
Schizophrenia is classified as a chronic mental disorder. It frequently induces relapse that can negatively impact the person and their family’s quality of life. This crosssectional study explored the main effect and interaction effect of factors related to relapse in people with schizophrenia. Three hundred fifty-two participants were included in this study. Four instruments used to collect data: a demographic data form; a Brief Psychotic Rating Scale; Medication Taking Behavior, and Perceived Social Support from Family scales. Descriptive statistics and binary logistic regression were used to analyze data.
Identified factors that can explain relapse in people with schizophrenia were the age of onset of schizophrenia, medication adherence, and the interaction effect between family history of psychiatric disorders and family support. Thus, the important implication for nursing practice is to develop an intervention that emphasizes family support to encourage people with schizophrenia to continue taking medication and develop effective mechanisms to cope with medication side-effect and stressful life event to prevent relapse for this population. In addition, close monitoring should be emphasized for those who have a family history of psychiatric disorders and earlier age of illness.
References
World Health Organization, Schizophrenia [Internet]. 2019 [cited 2020 January 19]. Available from https://
www.who.int/news-room/fact-sheets/detail/schizophrenia.
Alvarez-Jimenez M, Priede A, Hetrick SE, Bendall S, Killackey E, Parker AG, et al. Risk factors for relapse following treatment for first-episode psychosis: A systematic review and meta-analysis of longitudinal studies. Schizophr Res.2012; 139(1-3): 116-28.
Galletly C, Castle D, Dark F, Humberstone V, Jablensky A, Killackey E, et al. Royal Australian and New Zealand
College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders. Aust N Z J Psychiatry. 2016;50(5):1-117. doi: 10.1177/0004867416641195.
Harvey PD, Strassnig MT, Silberstein JS. Prediction of disability in schizophrenia: Symptoms, cognition, and selfassessment. J Exp Psychopathol. 2019, 1(20):1-20.doi:10.1177/2043808719865693.
Chadda RK. Caring for the family caregivers of people with mental illness. Indian J Psychiatry. 2014; 56(3):
-7. doi: 10.4103/0019-5545.140616.
Ahmad I, Khalily MT, Hallahan B, Shah I. Factors associated with psychotic relapse in patients with schizophrenia in a Pakistani cohort. Int J Ment Health Nurs. 2017;26(4):384-90. doi: 10.1111/inm.12260.
Adebiyia MO, Mosakub SK, Irinoyec OO, Oyeladec OO. Socio-demographic and clinical factors associated with
relapse in mental illness. Int J Afr Nurs Sci. 2018; 8:149-53.doi: 10.1016/j.ijans.2018.05.007.
Ciudad A, San L, Bernardo M, Olivares JM, Ciudad A, San L, et al. Relapse and therapeutic interventions in a
-year observational cohort study of nonadherent outpatients with schizophrenia. Prog Neuropsychopharmacol Biolo Psychiatry. 2012;36:245-50. doi:10.1016/j.pnpbp. 2011.10.014.
Zanetti ACG, Vedana KGG, Gherardi-Donato ECS, Galera SAF, Martin IS, Tressoldi LS, Miasso AI. Expressed emotion of family members and psychiatric relapses of patients with a diagnosis of schizophrenia. Rev Esc de Enferm USP. 2018; 52(e03330):1-7. doi: 10.1590/s1980-220x2016042703330.
García-Laredo E, Cognitive Impairment in Schizophrenia: Description and Cognitive Familiar Endophenotypes. A Review of the Literature [Internet]. 2018 [cited 2020 January 19]. Available from https://www.intechopen.com/books/psychosis-biopsychosocial-and-relational-perspectives/cognitive-impairment-in-schizophrenia-descriptionand-cognitive-familiar-endophenotypes-a-review-of-.
Settem JVV, Karanadi H, Praharaj SK. Cognitive deficits, depressive symptoms, insight, and medication adherence in remitted patients with schizophrenia. Indian J Psychiatry.2019; 61(4):335-41.
Latipun L, Amalia DR, Relation Social Support and Psychological Well-Being among Schizophrenic Patients: Self-Care as Mediation variable? [Internet]. 2019 [cited 2020 January 19]. Available from https://download.atlantis-press.com/article/55914349.pdf.
Suttajit S, Pilakanta S. Impact of depression and social support on non adherence to antipsychotic drugs in persons with schizophrenia in Thailand. Patient Prefer Adherence. 2010; 4:363-8. doi:10.2147/ppa.s12412.
Dyer T, Schizophrenia and substance abuse [Internet]. 2018 [cited 2020 January 19]. Available from https://www.drugrehab.com/co-occurring-disorder/schizophrenia/.
Nuecheterlein KH, Dawson ME, Gitlin M, Ventura J, Goldstein MJ, Synder KS, et al. Developmental processes in schizophrenic disorders: Longitudinal studies of vulnerability and stress. Schizophr Bull. 1992; 18(3):387-425.
Nuechterlein KH, Dawson ME, Ventura J, Gitlin M, Subotnik KL, Snyder KS, et al. The vulnerability/stress
model of schizophrenic relapse: A longitudinal study. Acta Psychiatr Scand. 1994; 89(s382):58-64.
Ratanasomporn K. Predicting factors of psychiatric symptoms in people with schizophrenia [Master Thesis].
Bangkok: Chulalongkorn University; 2013 (in Thai).
Phanthunane P, Vos T, Whiteford H, BertramM, Udomratn P. Schizophrenia in Thailand: Prevalence and burden of disease. Popul Health Metr. 2010; 8(24):1-8. doi:10.1186/1478-7954-8-24.
Worasing S, Hengudomsup P, Naebkaset C. Factors related to perceived stigma among patients with schizophrenia. Thai Pharmaceut Health Sci. 2014; 9(3):98-104 (in Thai).
Posri A. Family and community participation in caring of chronic schizophrenic patients: Study of Nongnasang community. J Royal Thai Army Nurs. 2018; 19:239-47 (in Thai).
Tungpunkom P, Napa W, Chaniang S, Srikhachin P. Caregiving experiences of families living with persons with schizophrenia:a systematic review. JBI Database System Rev Implement Rep. 2013; 11(8):415-564. doi: 10.11124/jbisrir2013-881.
Goldberg J, How to avoid a schizophrenia relapse [Internet]. 2018 [cited 2019 April 22]. Available from http://www.webmd.com/schizophrenia/guide/prevent-schizophreniarelapse.
Grove SK, Burns N, Gray JR. The practice of nursing research: Appraisal, synthesis, and generation of evidence (7th ed.). St. Louis, Missouri: Elsevier Saunders; 2013.
Overall JE, Gorham DR. The brief psychiatric rating scale. Psychol Rep. 1962;10:799-812.
Kittirattanapaiboon P. Brief Psychotic Rating Scale (BPRS)-Thai version. Department of Mental Health; 2001 (in Thai).
Nuechterlein KH, Miklowitz DJ, Ventura J, Gitlin MJ, Stoddard M, Lukoff D. Classifying episodes in schizophrenia and bipolar disorder: Criteria for relapse and remission applied to recent-onset samples. Psychiatry Res. 2006;144(2-3):153-66.doi: 10.1016/j.psychres.2004.04.018.
Sakthong P, Sonsa-Ardjit N, Sukarnjanaset P, Munpan W, Suksanga P. Development and psychometric testing of the medication-taking behavior tool in Thai patients. Int J Clin Pharm. 2016; 38(2):438-45.
Procidano ME, Heller K. Measures of perceived social support from friends and from family: Three validation
studies. Am J Community Psychol. 1983; 11(1):1-24.
Xiaoying L. Family social support and self-care ability among stroke survivors [Master Thesis]. Chiang Mai:
Chiang Mai University; 1999.
Immonen J, Jääskeläinen E, Korpela H, Miettunen J. Age at the onset and the outcomes of schizophrenia: A systematic review and meta-analysis. Early Interv Psychiatry. 2017;11:453-60. doi: 10.1111/eip.12412.
The National Health Service, Schizophrenia-Treatment [Internet]. 2019 [cited 2020 January 19]. Available from http://www.nhs.uk/conditions/schizophrenia/ treatment/
Peek C, Im-em W, Tangthanaseth R, The state of Thailand’s population 2015:“Features of Thai families in the era of low fertility and longevity” [Internet]. 2016 [cited 2019 December 15]. Available from https://thailand.unfpa.org/en/publications/state-thailand%E2%80%99spopulation-report-2015.
Petcharat B, Suwaluk Y. Factors related to caregivers’ caring behaviors for chronic schizophrenic patients at home.Songklanagarind Med J. 2003; 21(4):249-58 (in Thai).
Poonnotok P, Thampanichawat W, Patoomwan A, Sangon S. Struggling to restore normalcy: Thai parents’ experiences in being caregivers of children with early schizophrenia. Pac Rim Int J Nurs Res. 2016; 20(1):71-84.
Anab E, Onyango AC, Mwenda C. Caregiver’s knowledge and attitude regarding care for schizophrenia at Mathari Teaching and Referral Hospital, Kenya. Am. J. Psychiatr. Neurosci.2018; 6(1):15-27. doi: 10.11648/j.ajpn.
13.
Downloads
Published
How to Cite
Issue
Section
License
Copyright: The Pacific Rim International Journal of Nursing Research, Thailand Nursing & Midwifery Council has exclusive rights to publish, reproduce and distribute the manuscript and all contents therein.
.png)
