Predictors of relapse in Chinese schizophrenia patients: a prospective, multi-center study.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Beijing Anding Hospital, Capital Medical University, Beijing, China.
Yu-Tao
YT
Xiang
Chuan-Yue
CY
Wang
Yong-Zhen
YZ
Weng
Qi-Jing
QJ
Bo
Helen F K
HF
Chiu
Sandra S M
SS
Chan
Edwin H M
EH
Lee
Gabor S
GS
Ungvari
D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage; D002681:China; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017533:Marital Status; D055118:Medication Adherence; D016016:Proportional Hazards Models; D018967:Risperidone / Q000008:administration & dosage*; D012559:Schizophrenia / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy*; D055502:Secondary Prevention; D012720:Severity of Illness Index; D012917:Social Adjustment
D014150:Antipsychotic Agents; D018967:Risperidone