By Anyansi, Maria A. Nwakaego
The aim of this 10-year retrospective study was to investigate the factors associated with relapse in patients with schizophrenia at the Federal Neuropsychiatric Hospital, Enugu - Nigeria between January, 2005 and December, 2014. Schizophrenia is characterised by cognitive and emotional dysfunctions including delusions and hallucinations, disorganized speech and behaviour, and inappropriate emotions. Multiple schizophrenic relapses devastate the lives of both the patients and their families. The study examined the prevalence of schizophrenic relapse, identified the factors influencing relapses and examined the treatment /management strategies for schizophrenia in the facility. Convenience sampling method was used to select hospital case notes of 498 relapsed patients (260 males and 238 females). Data were collected using a researcher-designed proforma. Hypotheses were tested with multivariate logistic regression analysis at 0.05 probability level. The prevalence rate of relapse was 60.6%. Poor medication compliance (97.0%), substance abuse (7.6%), co-morbid mental illnesses (4.6%), and stressful life events (11.4%) were associated with schizophrenic relapse in the facility. Psychotherapy and other psychosocial approaches (such as Community Mental Health Services [CMS]) were lacking in the treatment approach. Clinical psychologists were not in the hospital mental health team. Employment of clinical psychologists and implementation CMS in the hospital were recommended. Deficient data recordings in the patents’ case notes and hospital admission and discharge registers, difficulty in retrieving patients’ case notes were some of the limitations of the study. Improved documentation methods-use of electronic documentation, was recommended. Further research on the nature of each of the factors influencing schizophrenic relapse was recommended.