title: Factors associated with psychotic relapse in patients with schizophrenia in a Pakistani cohort.
abstract: Despite a large body of research evaluating factors associated with the relapse of psychosis in schizophrenia, no studies in Pakistan have been undertaken to date to identify any such factors, including specific cultural factors pertinent to Pakistan. Semistructured interviews and psychometric measures were undertaken with 60 patients diagnosed with schizophrenia (49 male and 11 female) and their caregivers at four psychiatric hospitals in the Peshawar region in Pakistan. Factors significantly associated with psychotic relapse included treatment non-adherence, comorbid active psychiatric illnesses, poor social support, and high expressed emotion in living environments (P < 0.05). The attribution of symptoms to social and cultural values (97%) and a poor knowledge of psychosis by family members (88%) was also prevalent. In addition to many well-documented factors associated with psychotic relapse, beliefs in social and cultural myths and values were found to be an important, and perhaps treatable, factor associated with relapse of psychosis in Pakistan. The provision of evidence-based psychotherapeutic interventions, such as behaviour and family therapy and cognitive behaviour therapy for psychosis, could potentially ameliorate the relapse rate of psychosis in Pakistan.
authors.affiliation: Department of Psychology, International Islamic University Islamabad, Islamabad, Pakistan.
authors.forename: Irshad
authors.initials: I
authors.lastname: Ahmad
authors.affiliation: Department of Psychology, International Islamic University Islamabad, Islamabad, Pakistan.
authors.forename: Muhammad Tahir
authors.initials: MT
authors.lastname: Khalily
authors.affiliation: Department of Psychiatry, National University of Ireland, Galway, Ireland.
authors.forename: Brian
authors.initials: B
authors.lastname: Hallahan
authors.affiliation: Department of Psychology, University of Malakand, Khyber Pakhtunkhwa, Pakistan.
authors.forename: Inayat
authors.initials: I
authors.lastname: Shah
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003469:Culture; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D010154:Pakistan; D012008:Recurrence; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy / Q000209:etiology*; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
keywords: culture; relapse of psychosis; schizophrenia