title: Perceptions of relapse risks following first-episode psychosis and attitudes towards maintenance medication: a comparison between nursing and social work professionals.
abstract: OBJECTIVE
  Existing clinical guidelines have not yet identified an optimal duration of maintenance antipsychotic drug treatment for stable, remitted first-episode psychosis patients. This study compares the perception of relapse risk and attitudes towards maintenance medication among professionals in nursing and social work fields who have direct clinical experience with first-episode psychosis patients. We explore a perception model that identifies the decision-making factors in the clinical dilemma between relapse and maintenance.
  
  
  METHODS
  A specially designed survey addressing perceptions of relapse risk and optimal duration of maintenance treatment was conducted among 63 experienced health-care professionals (30 nurses and 33 social workers) in the field of early psychosis in Hong Kong.
  
  
  RESULTS
  Two clinically relevant themes were identified that affected professionals' judgment on the optimal duration of maintenance treatment in stable, remitted first-episode psychosis patients: (i) the remission period; and (ii) professionals' perceptions of relapse risk involved in medication discontinuation. The remission period was a significant predictor of the perceived relapse risk. Compared with social workers, mental health nurses perceived a higher relapse risk for patients before Bonferroni adjustment.
  
  
  CONCLUSIONS
  The three key clinical components discussed--remission period, perceived relapse risk and perceived optimal duration of maintenance treatment--are interconnected, collectively influencing health-care professionals' attitudes towards relapse and maintenance for patients. Our study identified differences between the perceptions of nursing and social work professionals, indicating a need for communication and discussion among professional groups in order to arrive at a coherent, efficacious team consensus.
authors.affiliation: Department of Psychiatry, The University of Hong Kong Department of Psychiatry, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong.
authors.forename: Kevin K-S
authors.initials: KK
authors.lastname: Chan
authors.forename: Queenie P M
authors.initials: QP
authors.lastname: Chin
authors.forename: Jennifer Y M
authors.initials: JY
authors.lastname: Tang
authors.forename: Julia
authors.initials: J
authors.lastname: Longenecker
authors.forename: Christy L M
authors.initials: CL
authors.lastname: Hui
authors.forename: Cindy P Y
authors.initials: CP
authors.lastname: Chiu
authors.forename: May M L
authors.initials: MM
authors.lastname: Lam
authors.forename: Gloria H Y
authors.initials: GH
authors.lastname: Wong
authors.forename: Eric Y H
authors.initials: EY
authors.lastname: Chen
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D009740:Nursing Staff / Q000523:psychology; D010465:Perception; D011568:Psychiatric Nursing; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology*; D012008:Recurrence; D012307:Risk Factors; D012720:Severity of Illness Index; D012949:Social Work, Psychiatric; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents