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Relapsing versus non relapsing course of schizophrenia: a cohort study in a community based mental health service

Published online by Cambridge University Press:  18 May 2011

Vittorio Di Michele ,
Francesca Bolino ,
Monica Mazza ,
Rita Roncone  and
Massimo Casacchia
Vittorio Di Michele*
Affiliation:
Department of Mental Health, Mental Health Center of Pescara, Pescara, Italy University of L'Aquila, Department of Psychiatry, L'Aquila, Italy
Francesca Bolino
Affiliation:
Department of Mental Health, Mental Health Center of Pescara, Pescara, Italy
Monica Mazza
Affiliation:
University of L'Aquila, Department of Psychiatry, L'Aquila, Italy
Rita Roncone
Affiliation:
University of L'Aquila, Department of Psychiatry, L'Aquila, Italy
Massimo Casacchia
Affiliation:
University of L'Aquila, Department of Psychiatry, L'Aquila, Italy
*
Address for correspondence: Dr. V. Di Michele, via Berardinucci 95, 65123 Pescara (Italy). Fax: +39-085-4253440 E-mail: vdimich@tin.it
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Summary

Aim - We examined the effect of several clinical variables on the tendency to relapse and to require hospitalization in a cohort of patients, living in the community and followed up naturalistically for seven years. Method - Forty-six patients affected by schizophrenia and schizoaffective disorder, according to both DSM-IV and ICD-10 criteria, were assessed by Positive and Negative Syndrome Scale and Life Skills Profile (LSP). All patients consecutively enrolled, were assessed in a stable clinical phase of illness and treated as usual by their reference psychiatrist. Social and clinical outcome was assessed yearly for seven years after the study entry and analyzed with survival analysis. Results - Patients who did not relapse, were characterized by higher functioning, lower positive symptoms, higher ability in self-care and non-turbulence and higher IQ at their baseline clinical evaluation. These variables were entered in a Cox regression model to corroborate the predictive power on the relapsing course of illness. Only IQ and non-turbulence scores of LSP were entered in the equation (Wald method: p=0.007 and p=0.002 respectively). Conclusions - Several factors interact with the course of illness and influence the tendency to require hospitalization. In the present study we report that non-turbulence is a significant predictor of a non-relapsing course of illness. Further studies are needed to clarify the role of other mediating variables.

Declaration of Interest: none.

Keywords

schizophreniahospitalizationoutcomecommunity psychiatry.
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 16 , Issue 1 , March 2007 , pp. 50 - 58
Copyright
Copyright © Cambridge University Press 2007

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