Perception of patients and caregivers towards protective and risk factors for relapse in first-episode schizophrenia

Abstract

Schizophrenia is a common public health problem in Thailand. Antipsychotic drugs are effective in First-Episode Schizophrenia (FES) patients. However, FES patients have a chance of relapse, which can impair mental functions, imposing a burden on family and society. Factors related to relapse are multifactorial and divergent among cultures. Identifying the right factors would help prevent the relapse. The aim of the present qualitative research study was to study protective and risk factors related to relapse in FES from perspectives of patients and caregivers. Participants were ten of FES patients who had been diagnosed with schizophrenia within two years from a tertiary psychiatric hospital of northeastern Thailand; and ten of their primary caregivers. Data were collected by audio records using a semi-structured interview schedule and in-depth interviews. Content analyses were used to determine patients and caregiver’s perception of factors that influence relapse risk. Results showed that protective factors for relapse in FES were related to drug adherence (continuous use of drugs, good insight, and understanding side effects of medication), and family supportiveness (competent caregiver, literacy on schizophrenia, and positive family’s attitude). Meanwhile, risk factors were drug non-adherence (uncontinuous use of drugs, lack of insight, and self-discontinuation of medication), family unsupportiveness (incompetent caregiver, illiteracy on schizophrenia, negative family’s attitude, and poverty), substance abuses, psychosocial stress, and natural course of disease. To conclude, health professionals should continuously monitor all protective and risk factors in order to prevent psychotic relapse in FES.