Predictors of relapse in Chinese schizophrenia patients: a prospective, multi-center study
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Relapse prevention is the main goal of maintenance treatment in schizophrenia. This study aimed to determine the rate and the socio-demographic and clinical predictors of relapse in Chinese schizophrenia patients following treatment of the acute phase of the illness.
In a multi-center, randomized, controlled, longitudinal study, 404 patients with schizophrenia who were clinically stabilized following an acute episode were randomly assigned to either the maintenance (i.e., initial optimal therapeutic doses continued throughout the study) or the dose-reduction group (i.e., initial optimal therapeutic doses continued for 4 or 26 weeks followed by a 50% dose reduction that was maintained until the end of the study). Participants were interviewed at entry using standardized assessment instruments, and followed up for 12–26 months.
In univariate analyses, relapse was significantly associated with the membership of the dose-reduction group, poor medication adherence, and having a diagnosis of the paranoid type of schizophrenia. In Cox proportional-hazards regression analysis the membership of the dose-reduction group, poorer medication adherence, more severe drug-induced side effects and prominent paranoid symptoms independently predicted a higher risk of relapse.
The study confirmed the importance of maintenance medication in preventing relapse in Chinese schizophrenia patients underscoring the risk of relapse associated with lack of treatment adherence, severe side effects and the patients’ paranoid attitude. Socio-demographic characteristics were not associated with relapse in Chinese schizophrenia patients. Potential residual confounding caused by unmeasured variables should be fully considered in future studies.
KeywordsSchizophrenia Maintenance treatment Relapse Paranoid China
This study was supported by grants from the 10th National Five-Year Plan Foundation of the Ministry of Science and Technology Program, People’s Republic of China (No. 2004BA720A22), the Research Foundation of the Xian-Janssen Pharmaceutical Company (No. RIS-CN-MCCT-0201), the National Natural Science Foundation of China (No. 30800367), and the Beijing Nova Program of the Beijing Municipal Science and Technology Commission (No. 2008B59).
Conflict of interest
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