title: Psychotic relapse and associated factors among patients attending health services in Southwest Ethiopia: a cross-sectional study.
abstract: Psychotic relapse leads to repeated hospitalization and negatively affects the clinical prognosis of the patients. Information on prevalence of relapse among patients with psychotic disorders in Ethiopian setting is scarce. This study aimed to assess the prevalence of relapse among patients with psychotic disorders attending services in Jimma University Specialized Hospital (JUSH).
  
  
  
  Data were collected using interviewer administered questionnaire. We used medication adherence rating scale (MARS) to assess compliance to medication and abnormal involuntary movement scale (AIMS) to detect medication side effects. Logistic regression analysis was used to identify independent predictors of psychotic relapse. All variables with P-value <0.25 in the bivariate analyses were entered into multivariate logistic regression and variables with P-value < 0.05 in the final model were declared to be significantly associated with the outcome variable.
  
  
  
  The prevalence of relapse among patients with psychotic disorder was 24.6 % (n = 95). Of this, 25.4 and 22.4 % were males and females respectively. The odds of developing psychotic relapse among patients living with family was 72 % lower than that of patients living alone (aOR = 0.28, 95 % CI = 0.08, 0.93). The odds of developing psychotic relapse among patients compliant to medication was 69 % lower than that of patients who were not compliant to medications (aOR = 0.31, 95 % CI = 0.12, 0.80). The odds of developing psychotic relapse among patients having high score on social support score was 48 % lower than that of patients who were compliant to medications (aOR = 0.52, 95 % CI = 0.28, 0.95). The odds of developing psychotic relapse among patients reporting to have sought religious support was 45 % lower than that of patients who have not sought religious support (aOR = 0.55, 95 % CI = 0.31, 0.96). On the other hand, the odds of developing psychotic relapse among participants who have experienced medication side effects was 1.83 times higher when compared to those who have never experienced medication side effects (aOR = 1.83, 95 % CI = 1.01, 3.31).
  
  
  
  The high prevalence of relapse among patients with psychotic disorder needs special attention. Clinicians need to pay attention to medication side effects the patient faces. Intervening noncompliance to medication and appropriately managing medication side effects may help in preventing psychotic relapse that may result because of non-compliance. The provision of counseling, psycho education, psycho social support may help patients in improving compliance to medication and reducing psychotic relapse. Developing and strengthening community based rehabilitation services should be emphasized as part of mental healthcare services.
authors.affiliation: Amanuel Mental Health Specialized Hospital, Addis Ababa, Ethiopia.
authors.forename: Mahlet
authors.initials: M
authors.lastname: Fikreyesus
authors.affiliation: Department of Psychiatry, Jimma University, Jimma, Ethiopia.
authors.forename: Matiwos
authors.initials: M
authors.lastname: Soboka
authors.affiliation: Department of Health Education and Behavioral Science, Jimma University, Jimma, Ethiopia. garumma.feyissa@adelaide.edu.au.|The Joanna Briggs Institute, University of Adelaide, Adelaide, Australia. garumma.feyissa@adelaide.edu.au.
authors.forename: Garumma Tolu
authors.initials: GT
authors.lastname: Feyissa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000523:psychology; D012008:Recurrence; D012944:Social Support; D055815:Young Adult; D016903:Drug Monitoring
keywords: Ethiopia; Medication compliance; Medication side effect; Psychotic disorders; Relapse; Substance use