Associations Between Relapses and Psychosocial Outcomes in Patients With Schizophrenia in Real-World Settings in the United States

Abstract

Aim: To assess associations between relapses and psychosocial outcomes in adult patients with schizophrenia treated in United States (US) healthcare settings.Methods: Data were derived from a point-in-time survey of psychiatrists and their patients with schizophrenia conducted across the US, France, Spain, China, and Japan between July and October 2019. For the purposes of this analysis, only data from US practitioners and patients were included. Disease-specific programmes (DSPs) are large surveys with a validated methodology conducted in clinical practise; they describe current disease management, disease burden, and associated treatment effects (clinical and physician-perceived). Participating psychiatrists completed patient record forms for their next 10 consecutive adult consulting patients with schizophrenia, with the same patients invited to voluntarily complete a patient self-completion (PSC) questionnaire. Surveys contained questions on the patients' disease background, treatment history, prior hospitalisation due to schizophrenia relapse and a series of psychosocial outcomes. Associations between relapses in the last 12 months and psychosocial outcomes were examined using multiple regression.Results: A total of 124 psychiatrists provided data on 1,204 patients. Of these, 469 patients (mean age, 39.6 years; 56.5% male) had known hospitalisation history for the last 12 months and completed a PSC; 116 (24.7%) patients had ≥1 relapse. Compared to patients without relapses, patients who relapsed were more likely to be homeless, unemployed, previously incarcerated, and currently have difficulties living independently (all p < 0.05). Patients who experience a relapse also had greater working impairment and poorer quality of life compared with those who did not relapse. In general, psychosocial outcomes became poorer with an increasing number of relapses.Conclusions: In this population of patients with schizophrenia from the US, relapse was significantly associated with poor psychosocial outcomes, with a greater number of relapses predicting worse outcomes. Early intervention to reduce the risk of relapse may improve psychosocial outcomes in patients with schizophrenia.

Prevalence of functional disability and associated factors among patients with schizophrenia attending psychiatry outpatient clinic at Muhimbili national hospital, Dar es Salaam: A cross-sectional survey

“…This is explainable by the possibility that multiple admissions may re ect the frequencies of relapses of schizophrenia, where the more the relapses the poor functioning (70). Similar ndings reported in a multinational study involving the United States of America, China, France, Spain, and Japan showing multiple relapses to be associated with functional disability among schizophrenia patients (71). Different results found in a Nigerian study among schizophrenia patients, which showed that there was no difference in odds of functional disability among patients who never admitted and those who had one or more admissions (11).…”

Prevalence of Functional Disability and Associated Factors Among the Patients With Schizophrenia Attending Psychiatry Outpatient Clinics at Muhimbili National Hospital, Dar Es Salaam, Tanzania. Cross-sectional Survey

“…This is explainable by the possibility that multiple admissions may re ect the frequencies of relapses of schizophrenia, where more relapses are associated with poor functioning (70). Similar ndings reported in a multinational study involving the United States of America, China, France, Spain, and Japan showing multiple relapses to be associated with functional disability among schizophrenia patients (71). Different results found in a…”

Comparing Relapse Rates in Real-World Patients with Schizophrenia Who Were Adequately versus Not Adequately Treated with Paliperidone Palmitate Once-Monthly Injections Before Transitioning to Once-Every-3-Months Injections

“…In a recent survey of psychiatrists and their patients with schizophrenia, patients with fewer relapses in the 12-month span prior to the survey experienced better quality of life, higher levels of employment, fewer symptoms, and greater participation in social interactions. 22 Therefore, careful consideration of adequate treatment before transition between LAI formulations is important for preserving psychosocial functioning and improving clinical outcomes. As longer-acting LAIs, such as PP6M, become available for use, further investigations will be required to determine if a similar stabilization period may be required for optimal post-transition outcomes.…”