Factors Associated with Relapse in Schizophrenia (Report‪)‬

Schizophrenia is a chronic and disabling illness that affects approximately 1% of the world's population. It is often accompanied by relapse even while on treatment. (1) Relapse rates vary from 50% to 92% (2) and are similar in developed and developing countries, despite the former having well-established mental health services. Among South Africans, there are few published data regarding the prevalence and factors associated with relapses; this study was intended to address that need. Relapse in schizophrenia is broadly recognised as the reemergence or the worsening of psychotic symptoms. More specifically, certain criteria are used to define relapse; they include aggravation of positive or negative symptoms, hospital admission in the past 6 months, and more intensive case management and/or a change in medication. (3) Relapse may result in hospitalisation, treatment resistance, cognitive impairment owing to progressive structural brain damage, personal distress, incarceration, and interference with rehabilitation efforts. (4) Relapse increases the economic burden on health care systems because of its associated morbidity and re-admissions to hospital. Prevention of relapses could have significant therapeutic and socio-economic implications. (3,5) Internationally, the factors commonly associated with relapse include poor adherence to treatment, substance abuse, co-morbid psychiatric illness, a co-morbid medical and/or surgical condition, stressful life events, and the treatment setting. (6,7)