Medication-adherent first-episode psychosis patients also relapse: why?

Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie
Emmanuelle LevyAshok K Malla

Abstract

Poor adherence to medication is a major determinant of relapse following treatment of first-episode psychosis (FEP). However, medication-adherent patients also relapse. We examined what factors influence the risk of relapse after controlling for adherence. We selected a sample of fully adherent patients (n = 65) who had achieved remission at one point. We then compared patients who relapsed, using 2 different definitions of relapse, to those who did not relapse by 12 months on age, sex, premorbid adjustment, duration of untreated psychosis, length of prodrome, and substance abuse. Among the 65 medication-adherent patients in remission, 9 (14%) relapsed according to criteria for relapse requiring a change in medication. These patients differed from those who remained in remission only in the pattern of premorbid adjustment (greater proportion with deteriorating pattern), although this was not independent of other variables. No differences were found on any other variable. Using a more commonly used metric for relapse, based on symptom ratings alone, an additional 14 (21.5%) patients relapsed. Substance abuse significantly predicted relapse, with substance abusers having more than 25 times the odds of relapsing by 12 months (OR 2...Continue Reading

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Citations

Sep 21, 2013·Schizophrenia Bulletin·Saeed FarooqGary Remington
Jun 13, 2013·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·Anne E RhodesIan Manion
Aug 16, 2013·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·Rahul ManchandaNicola Banks
Sep 4, 2020·Current Psychiatry Reports·Philip HensonJohn Torous

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