TY - JOUR
T1 - Clinical factors related to schizophrenia relapse
AU - Porcelli, Stefano
AU - Bianchini, Oriana
AU - De Girolamo, Giovanni
AU - Aguglia, Eugenio
AU - Crea, Luciana
AU - Serretti, Alessandro
PY - 2016
Y1 - 2016
N2 - OBJECTIVE:
Relapses represent one of the main problems of schizophrenia management. This article reviews the clinical factors associated with schizophrenia relapse.
METHODS:
A research of the last 22 years of literature data was performed. Two-hundred nineteen studies have been included.
RESULTS:
Three main groups of factors are related to relapse: factors associated with pharmacological treatment, add-on psychotherapeutic treatments and general risk factors. Overall, the absence of a maintenance therapy and treatment with first generation antipsychotics has been associated with higher risk of relapse. Further, psychotherapy add-on, particularly with cognitive behaviour therapy and psycho-education for both patients and relatives, has shown a good efficacy for reducing the relapse rate. Among general risk factors, some could be modified, such as the duration of untreated psychosis or the substance misuse, while others could not be modified as male gender or low pre-morbid level of functioning.
CONCLUSION:
Several classes of risk factors have been proved to be relevant in the risk of relapse. Thus, a careful assessment of the risk factors here identified should be performed in daily clinical practice in order to individualise the relapse risk for each patient and to provide a targeted treatment in high-risk subjects.
KEYWORDS:
Drug; psychotherapy; relapse; schizophrenia
AB - OBJECTIVE:
Relapses represent one of the main problems of schizophrenia management. This article reviews the clinical factors associated with schizophrenia relapse.
METHODS:
A research of the last 22 years of literature data was performed. Two-hundred nineteen studies have been included.
RESULTS:
Three main groups of factors are related to relapse: factors associated with pharmacological treatment, add-on psychotherapeutic treatments and general risk factors. Overall, the absence of a maintenance therapy and treatment with first generation antipsychotics has been associated with higher risk of relapse. Further, psychotherapy add-on, particularly with cognitive behaviour therapy and psycho-education for both patients and relatives, has shown a good efficacy for reducing the relapse rate. Among general risk factors, some could be modified, such as the duration of untreated psychosis or the substance misuse, while others could not be modified as male gender or low pre-morbid level of functioning.
CONCLUSION:
Several classes of risk factors have been proved to be relevant in the risk of relapse. Thus, a careful assessment of the risk factors here identified should be performed in daily clinical practice in order to individualise the relapse risk for each patient and to provide a targeted treatment in high-risk subjects.
KEYWORDS:
Drug; psychotherapy; relapse; schizophrenia
KW - Drug
KW - psychotherapy
KW - relapse
KW - schizophrenia
KW - Drug
KW - psychotherapy
KW - relapse
KW - schizophrenia
UR - http://hdl.handle.net/10807/79120
U2 - 10.3109/13651501.2016.1149195
DO - 10.3109/13651501.2016.1149195
M3 - Article
SN - 1365-1501
VL - 20
SP - 54-69-69
JO - International Journal of Psychiatry in Clinical Practice
JF - International Journal of Psychiatry in Clinical Practice
ER -