Jarunee IntharitKhanogwan KittiwattanagulWisit ChaveepojnkamjornKukiat TudporKhon Kaen Rajanagarindra Psychiatric HospitalMahidol UniversityMahasarakham University2022-08-042022-08-042021-01-01F1000Research. Vol.10, (2021)1759796X204614022-s2.0-85119587595https://repository.li.mahidol.ac.th/handle/123456789/76324Background: Schizophrenia is a serious mental illness that can relapse after treatments. Risk and protective factors for relapse are dependent on multicultural contexts. Objective: To identify risk and protective factors related to relapse in first-episode schizophrenia (FES) in northeastern Thailand from perspectives of health professionals. Methods: This qualitative research collected data from 21 health professional staff members (psychiatric nurses, psychiatrists, psychologists, social workers, occupational therapists and nutritionist) of a tertiary psychiatric hospital of northeastern Thailand who had been involved in mental health care for schizophrenia for at least 5 years by in-depth interviews and group interview using semistructured interview schedule. Content analyses was used to identify staff perception of factors that put patients at risk of relapse. Results: Data analyses demonstrated that factors related to relapse in FES patients were drug adherence (drug discontinuation, limited access to new generation drugs, self-dose reduction and skipping medication, and poor insight), family factors (stressful circumstances and family supports), substance abuses (narcotics, addictive substances, caffeinated drinks), concurrent medical illness (insomnia, thyroid diseases, and pregnancy-related hormonal changes), and natural course of disease. Conclusion: Factors affecting relapse in FES was not only drug adherence. Family factors, drug abuses, and concurrent health status should be also taken into account. A comprehensive mental health care program should be developed for FES patients in the region.Mahidol UniversityBiochemistry, Genetics and Molecular BiologyImmunology and MicrobiologyPharmacology, Toxicology and PharmaceuticsArticleSCOPUS10.12688/f1000research.53317.1