Prevalence and predictors of treatment-resistant schizophrenia in a tertiary hospital in Northeast Brazil

Autor: Douglas de Sousa Soares, Danyelle Rolim Carvalho, Mellanie Dellylah Trinta Ribeiro, Elton Jorge Bessa Diniz, Alcides Ferreira Rêgo Neto
Jazyk: English<br />Spanish; Castilian<br />Portuguese
Rok vydání: 2021
Předmět:
Zdroj: Trends in Psychiatry and Psychotherapy (2021)
Druh dokumentu: article
ISSN: 2238-0019
2237-6089
DOI: 10.47626/2237-6089-2020-0151
Popis: Abstract Objective To investigate epidemiological factors related to treatment-resistant schizophrenia (TRS) in Northeast Brazil, a region where data about mental health are still scarce. Methods This retrospective cross-sectional study included all patients with schizophrenia currently receiving treatment at the outpatient psychiatric clinic of a tertiary hospital in Northeast Brazil. They were divided into TRS and treatment-responsive groups, and epidemiological characteristics of both groups were compared. A logistic regression model investigated factors related to treatment resistance. Results Two hundred and five patients were included, 155 treatment-resistant and 50 treatment-responsive. The TRS group had higher use of benzodiazepines (36.1 vs. 18%, p = 0.017) and antiepileptics (36.8 vs. 8.0%, p < 0.001), antipsychotic polypharmacy (28.6 vs. 8%, p = 0.003) and suicide attempts (35.6 vs. 20%, p = 0.04). Age at onset was younger (19.7±7.3 vs. 24.6±8.6 years, p = 0.001) and CGI was higher in TRS (3.72±1.00 vs. 3.16±1.00, p = 0.001). In logistic regression, being married was a protector (odds ratio [OR] = 0.248, 95% confidence interval [95%CI] 0.091-0.679, p = 0.007) and younger age at onset was a predictor (OR = 1.076, 95%CI 1.034-1.120, p < 0.001) of treatment resistance. Conclusion Early onset of disease was associated with more treatment resistance, while being married with less resistance. Clinicians should identify early predictors of resistance in order to reduce unfavorable outcomes.
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