Relapsing versus non relapsing course of schizophrenia: a cohort study in a community based mental health service

Abstract

SUMMARYAim - We examined the effect of several clinical variables on the tendency to relapse and to require hospitalization in a cohort of patients, living in the community and followed up naturalistically for seven years. Method - Forty-six patients affected by schizophrenia and schizoaffective disorder, according to both DSM-IV and ICD-10 criteria, were assessed by Positive and Negative Syndrome Scale and Life Skills Profile (LSP). All patients consecutively enrolled, were assessed in a stable clinical phase of illness and treated as usual by their reference psychiatrist. Social and clinical outcome was assessed yearly for seven years after the study entry and analyzed with survival analysis. Results - Patients who did not relapse, were characterized by higher functioning, lower positive symptoms, higher ability in self-care and non-turbulence and higher IQ at their baseline clinical evaluation. These variables were entered in a Cox regression model to corroborate the predictive power on the relapsing course of illness. Only IQ and non-turbulence scores of LSP were entered in the equation (Wald method: p=0.007 and p=0.002 respectively). Conclusions - Several factors interact with the course of illness and influence the tendency to require hospitalization. In the present study we report that non-turbulence is a significant predictor of a non-relapsing course of illness. Further studies are needed to clarify the role of other mediating variables.Declaration of Interest: none.

Predicting clinical and social outcome of patients attending ‘real world’ mental health services: a 6‐year multi‐wave follow‐up study

“…Our findings confirm the well-documented strong relationship between negative symptoms and social disability (46,47,60,61). However, we found this interaction to be bidirectional (levels of negative symptoms predict social disability after 6 years, but social disability also has a strong predictive value for levels of negative symptoms over the same period).…”

Predictors of changes in needs for care in patients receiving community psychiatric treatment: a 4‐year follow‐up study

“…The effectiveness of community services in avoiding deterioration of long-term patients has been substantially confirmed in other research conducted in similar treatment settings (24,26,28,(45)(46)(47), in contrast with a trend towards a worsening in patients cared for in different systems of care (14). Overall, both patientrated and staff-rated needs tended to remain substantially stable over time.…”

“…However, the finding that community care helped patients to reach some kind of stabilization should be regarded as encouraging, as at least one-third of the study cohort was composed by long-term patients, who -in most cases -displayed enduring symptoms and disabilities. The effectiveness of community services in avoiding deterioration of long-term patients has been substantially confirmed in other research conducted in similar treatment settings (24,26,28,(45)(46)(47), in contrast with a trend towards a worsening in patients cared for in different systems of care (14).…”

Peran Keluarga terhadap Manajemen Relapse (Kekambuhan) pada Orang Dengan Skizofrenia (ODS)

“…Penelitian yang dilakukan oleh Michele, Bolino, Mazza, Roncone, & Casacchia (2007) menyebutkan bahwa ODS yang tidak dalam keadaan relapse (keadaan stabil) memiliki karakteristik seperti, dapat berfungsi secara baik, simtom positif yang lebih rendah, memiliki kemampuan yang lebih tinggi dalam merawat diri. Evaluasi klinis awal pada ODS yang berada pada kondisi stabil juga menunjukan bahwa ODS memiliki IQ yang lebih tinggi (Michele, Bolino, Mazza, Roncone, & Casacchia, 2007). penderita tidak hanya terbatas pada perilaku minum obat, namun juga dalam keseharian ODS.…”