Factors associated with dropout at 2 years post-initiation of treatment in the first episode of schizophrenia
| Autor: | Robin Emsley, Lebogang Phahladira, Jebril M Benelmokhtar, Bonginkosi Chiliza, Laila Asmal |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Longitudinal study
medicine.medical_specialty flupenthixol decanoate lcsh:RC435-571 lcsh:RZ400-408 03 medical and health sciences 0302 clinical medicine lcsh:Psychiatry Internal medicine Medicine Psychiatric hospital adherence first episode Original Research First episode Positive and Negative Syndrome Scale business.industry positive and negative syndrome scale long acting injectable lcsh:Mental healing Odds ratio 030227 psychiatry schizophrenia Psychiatry and Mental health Cohort Dual diagnosis Age of onset business 030217 neurology & neurosurgery dual diagnosis |
| Zdroj: | South African Journal of Psychiatry, Volume: 27, Issue: 1, Pages: 1-7, Published: 2021 South African Journal of Psychiatry; Vol. 27 (2021) The South African Journal of Psychiatry : SAJP : the Journal of the Society of Psychiatrists of South Africa South African Journal of Psychiatry, Vol 27, Iss 0, Pp e1-e7 (2021) |
| ISSN: | 2078-6786 1608-9685 |
| Popis: | Background: Prevention of new episodes during the first 2 years after a first episode of schizophrenia (FES) may delay treatment refractoriness and brain morphological changes over time. However, adherence to treatment is characteristically poor in these patients. Aim: The aim of this study was to examine clinical and sociodemographic factors associated with patient dropout in patients with FES. Setting: This study was set at inpatient and outpatient services at a psychiatric hospital in the Western Cape, between 2007 and 2011. Methods: Data were collected as part of a prospective longitudinal study, which followed up patients with FES treated with flupenthixol decanoate. We examined the relationship between treatment adherence and sociodemographic and clinical factors at baseline and at 24 months. Unadjusted and adjusted logistic regression models were used to determine adherence variables. Results: A total of 62% of patients completed the 24 months of treatment. Participants with FES and a substance use disorder (dual diagnosis) were at greater risk of dropout (p = 0.01). On univariate analysis, dual diagnosis participants who dropped out were older (p = 0.04) had completed more years of schooling (p = 0.001), older age of onset (p = 0.02) and higher baseline positive symptoms (p = 0.05). On regression analysis, non-completer substance users achieved a higher level of education (odds ratio [OR]: 3.87, confidence interval [CI]: 1.34–11.11, p = 0.01). Conclusion: Substance use disorder was associated with non-adherence to follow up in a cohort of FES patients treated with flupenthixol decanoate. Interventions that take into account age, education and baseline positive symptoms may afford the opportunity to influence adherence and patient outcome. |
| Databáze: | OpenAIRE |
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