title: Clinical factors related to schizophrenia relapse.
abstract: OBJECTIVE
  Relapses represent one of the main problems of schizophrenia management. This article reviews the clinical factors associated with schizophrenia relapse.
  
  
  METHODS
  A research of the last 22 years of literature data was performed. Two-hundred nineteen studies have been included.
  
  
  RESULTS
  Three main groups of factors are related to relapse: factors associated with pharmacological treatment, add-on psychotherapeutic treatments and general risk factors. Overall, the absence of a maintenance therapy and treatment with first generation antipsychotics has been associated with higher risk of relapse. Further, psychotherapy add-on, particularly with cognitive behaviour therapy and psycho-education for both patients and relatives, has shown a good efficacy for reducing the relapse rate. Among general risk factors, some could be modified, such as the duration of untreated psychosis or the substance misuse, while others could not be modified as male gender or low pre-morbid level of functioning.
  
  
  CONCLUSIONS
  Several classes of risk factors have been proved to be relevant in the risk of relapse. Thus, a careful assessment of the risk factors here identified should be performed in daily clinical practice in order to individualise the relapse risk for each patient and to provide a targeted treatment in high-risk subjects.
authors.affiliation: a Department of Biomedical and NeuroMotor Sciences , University of Bologna , Bologna , Italy ;
authors.forename: Stefano
authors.initials: S
authors.lastname: Porcelli
authors.affiliation: a Department of Biomedical and NeuroMotor Sciences , University of Bologna , Bologna , Italy ;|b Institute of Psychiatry, University of Catania , Catania , Italy ;
authors.forename: Oriana
authors.initials: O
authors.lastname: Bianchini
authors.affiliation: c IRCCS Centro S. Giovanni di Dio, Fatebenefratelli , Brescia , Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: De Girolamo
authors.affiliation: b Institute of Psychiatry, University of Catania , Catania , Italy ;
authors.forename: Eugenio
authors.initials: E
authors.lastname: Aguglia
authors.affiliation: b Institute of Psychiatry, University of Catania , Catania , Italy ;
authors.forename: Luciana
authors.initials: L
authors.lastname: Crea
authors.affiliation: a Department of Biomedical and NeuroMotor Sciences , University of Bologna , Bologna , Italy ;
authors.forename: Alessandro
authors.initials: A
authors.lastname: Serretti
mesh_terms: D006801:Humans; D012008:Recurrence; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy / Q000517:prevention & control* / Q000628:therapy
keywords: Drug; psychotherapy; relapse; schizophrenia