A Cross-Sectional Study on Factors Associated with Relapse in Patients with Schizophrenia at Mathari Hospital, Nairobi Kenya

Abstract

Schizophrenia is a chronic and disabling mental disorder with a high prevalence rate of 1.4-4.6 per a thousand populations. Schizophrenia is often accompanied by relapses even while on treatment. Relapse rate vary from 50%-92% and are similar in both developed and developing countries, despite the former having well established Mental health services. This was a cross-sectional descriptive study of 209 family members or significant others accompanying patients to Mathari Hospital. Patients were selected by random sampling and the study was carried out between June and July 2011. Schizophrenia was diagnosed using Diagnostic and statistical manual of mental disorder, 4th edition text revision (DSM-IV-TR) criteria. Data was collected using semi-structured questionnaire and analyzed using Statistical package for social science (SPSS) and presented in frequency tables, bar graphs and pie charts. Relationship between independent and dependent variables was determined by calculating confidence interval and summary Chi-square statistics. P-value of < 0.05 was considered significant. The findings indicated that majority of patients (81.8%) were aged between 17-46 years with (54%) of patients having had their first episodes of schizophrenia between ages 17-26 years. The results showed that factors associated with relapse in schizophrenia in Mathari hospital included, non-drug compliance and failure to attend follow-up clinic (67.9%), stressful life events (17.3%), and substance abuse (14.8%). Relapse rate was found to be 58%-97%. This calls for intensified Psycho education to both patients and family members for early recognition of signs of relapse and drug compliance. Improvement of community mental health services will reach more family members in their homes, encourage drug compliance and community involvement in understanding schizophrenia to reduce stigma. Health policy makers will avail atypical antipsychotic drugs with minimal side effects to reduce the high relapse rate. Future research should focus on clinical factors associated with relapse in schizophrenia.