The Study About Regularity And Factors Of Relapse On First-episode Schizoprenia After One-years Follow Up

Objectives The study aimed at investigate the rules and correlates of relapse of firstepisode schizophrenia(FEP) by means of a 1year follow-up in the natural state.and we also aimed at explore the relationships between the elements and the relapse which could provide more theoretical foundation to the prevention of relapse.Methods Patients were inpatient admission recruited from four mental health institution of Hebei province include Mental Health Center in Hebei province,Mental Hospital of Hengshui,Mental Hospital of Cangzhou and Shalingzi Hosipital in Zhangjiakou from November,2013 to Febuary,2014,the patients are met criteria for a diagnosis of schizophrenia in DSM-IV,206 patients finished the scale assessment at the time of admission and discharge include the self-made general questio-nnaire,PANSS,CGIS,PSP,Zarit Caregiver burden scale,FBS,MARS.The patients were follow-up investigated in the third month,sixth month,ninth month,twelfth month after discharged.Results 1.At end of the study,185 patients finished the investigate.31 patients were relapse,The 1 year relapse rate of FEP is 16.57%.2.the results of T test or χ2test is The Family relationships prior to admission(t=-2.25,P=0.026)family relationships after relapse or At the end of follow-up(t=-2.51, P=0.013),medication adherence(t=-2.83,P=0.005),mode of onset(χ2=3.43,P=0.024),DUP(χ2=7.03,P=0.008),go to school or work after discharge(χ2=11.42,=0.001),individual’s burden of Caregivers(t=-2.83,P=0.005),Accountability of Caregivers(t=-2.01,P=0.046),General burden of Caregivers(t=-2.05,P=0.042),family’s financial burden(t=3.83,P=0.000),family entertainment burden(t=4.56,P=0.000) were significantly associated with relapse. the Binary Logistic regression analysis suggests that medication adherence(OR=0.49,95%CI=0.33 ~ 0.73),DUP(OR=4.71,95%CI=1.15 ~19.38),individual’s burden of Caregivers(OR=1.14,95%CI=1.00 ~ 1.29),family financial burden(OR=7.22,95%CI=1.17 ~ 44.40),family entertainment burden(OR=13.10,95%CI=1.39 ~ 123.42) were risk factors of relapse.while Accountability of Caregivers(OR=0.77,95%CI=0.63 ~ 1.35)was the protective factor of relapse.3.Logistic regression analysis found that mode of onset(OR=0.81,95%CI=0.66 ~ 0.98)was the risk factors of DUP and degree of care of family numbers to the patients(OR=11.27,95%CI=5.67~22.39) was the protective factor of DUP.4.multiple regression analysis found that go to school or work after discharge(t=4.64,P=0.000),total score of positive scale in admission(t=-2.33,P=0.021),total score of PANSS in discharge(t=2.82,P=0.005),lack of insight in discharge(G12)(t=-4.35,P=0.000)were correlates of medication adherence.5.The cumulative relapse rate of the third month,the sixth month,the ninth month,the twelfth month is 1.6%,4.2%,11.16%, 16.57%.After the curve fitting of the relapse rate of all the time points,The fitted equation is y=8.9683*10-4x2+0.0037x-0.0021,goodness of the fit is R2=0.9852.Conclusions 1.The patient’ medication adherence, DUP, family financial burden, family entertainment burden have a influence on the relapse of FEP.Improve the medication adherence of the patients’, shorten the DUP and provide psychological and material supports to the patient’s family may reduce the risk of recurrence of patients.2.The relapse rate of FEP increased gradually during the first year,The relapse rate of discharge after 1 year is high.The relapse rate of the patients in 1 year after discharged can be calculated accurately which can make the patients and their family members understand the importance of the prevention of relapse profoundly.As a result,the patients and their family members could cooperation with treatment more positive and prevent the relapase.