Six-month outcome following a relapse of schizophrenia

Objective: To analyse clinical data on patients with schizophrenia on admis sion to acute care and 6 months later in order to identify factors associat ed with frequent hospitalisations and poor outcome. Method: Information was collected from the medical records of 99 patients w ith schizophrenia consecutively admitted to acute care in hospital or by co mmunity based 24 h Crisis Teams and prospectively studied for 6 months. Results: One-quarter of patients were being admitted to acute care within 3 months of their last hospital discharge and only 34 patients were complian t with their neuroleptic medication 3 months prior to the index admission. Twenty-one patients were managed entirely by the Crisis Teams, 27 patients received inpatient care only and the remainder (n = 51) had both types of a cute care. Six months after admission, 42 patients had been discharged and did not require further acute care, 29 patients had been re-admitted at lea st once and three patients had been transferred to an inpatient rehabilitat ion unit and, therefore, remained in hospital over the entire period. Of th e remaining 25 patients, one committed suicide 2 months after discharge and the other patients were not contactable by Community Mental Health Teams a t the 2 and/or 6 month follow up. Conclusions: Some of the factors associated with relapse identified in the present study were non-compliance with medication, stress, inadequate socia l support and substance abuse. The poor outcome in patients with frequent r elapses emphasises the need to reduce the occurrences of schizophrenic symp toms to provide a better quality of life. The 25% of patients dropping out of care soon after a relapse indicates that more should be done to engage t hese people in long-term treatment programs.