The Lifetime Prevalence and Factors Associated with Relapse Among Mentally Ill Patients at Jimma University Medical Center, Ethiopia: Cross Sectional Study

Journal of Psychosocial Rehabilitation and Mental Health - 2020
Liyew Agenagnew1, Chalachew Kassaw2
1Department of Psychiatry, Faculty of Medical Sciences, Institute of Health, Jimma University, P.O. Box 378, Jimma, Ethiopia
2Department of Psychiatry, College of Health Science, Dilla University, P.O. Box 419, Dilla, Ethiopia

Tóm tắt

AbstractRelapse is a condition of getting back to illness after the recovery from illness. It results in stigma, high cost of treatments, and a decline in functionality both for patients and their families. It is common in mentally ill patients therefore this study attempted to assess lifetime prevalence and factors associated with relapse in a patient with mental illness. Institutional based cross-sectional study design was employed and simple random sampling techniques were used to select 178 study participants. Data were collected through face to face interviews by using a single item question to measure relapse. Data were entered by using Epi-data 3.1 software and exported to the statistical package for social science 22.0 software for analysis. Bivariate logistic regression analysis was conducted to see the association between dependent and independent variables and to identify significant variables associated with the outcome variable at P < 0.05 multivariable logistic regression analysis was done. One hundred seventy-eight mentally ill patients have participated in the study that yields a response rate of 100%. From all 125 (70.2%) of them had relapsed. Non adherance (AOR = 6.35, 95% CI, 2.524–15.852, P < 0.001), high disablity score (AOR = 3.728, 95% CI, 1.434–9.687, P = 0.007) and having single admission history (AOR = 0.196, 95% CI, 0.050–0.761 P = 0.019) were factors which indepedently associated with relapse of mentally ill patients. This study found more than two-thirds of patients had relapsed. Adherence to medication, functional disability, and having single admission were variables that predict the relapse of mentally ill patients.

Từ khóa


Tài liệu tham khảo

Metrics GH. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Psychiatry. 2018;392:1990–2017.

World Health Organization, Geneva, 2011.

Grace R, Onaiza Q, Natasha SJE. Mental health for global prosperity. London Sch Hyg Trop Med. 2019;(January):1–3.

Kazadi NJB, Moosa MYH, Jeenah FY. Articles factors associated with relapse in schizophrenia. Soc Anxiety J Psychiatry. 2008;14(2):52–3.

Swendsen J. Disorder. Am J Psychiatry. 1995;152:1635–40.

Doering S, Mutter E, Kopcke W, Pietzcker A, Qaebel W, Linden M, et al. Predictors of relapse and rehospitalization in schizophrenia and schizoaffective disorder. Schizophr Bull. 1998;24(1):87–98.

Dunn T. The association between medication adherence in mental illness and substance use disorder relapse in patients with dual diagnosis. Subst Abuse Addict J 2018; 100–105.

Vaughn BCE. The influence of family and social factors on the course of psychiatric illness. Br J Psychiatry. 1976;129:125–37.

Baguma C, Ashaba S. Portrayals of mental illness, treatment, and relapse and their effects on the stigma of mental illness: population-based, randomized survey experiment in rural Uganda. PLoS ONE Med. 2018;4:1–19. https://doi.org/10.1371/journal.pmed.1002908.

Rollins AL, O’Neill SJ, Davis KE, Devitt TS. Substance abuse relapse and factors associated with relapse in an inner-city sample of patients with dual diagnoses. Psychiatr Serv. 2005;56(10):1274–81.

Butzlaff RL, Hooley JM. Expressed emotion and psychiatric relapse. Arch Gen Psychiatry. 1998;55(6):547–52.

Di S, Rachel C, Mallikarjun P. The relapse rate and predictors of relapse in patients with first-episode psychosis following discontinuation of antipsychotic medication. Early Interv Psychiatry. 2018;12(5):893–9. https://doi.org/10.1111/eip.12385Epub 2016 Oct 13.

Hayes JF, Osborn DPJ, Lundin A, Dalman C. Psychiatric hospitalization following antipsychotic medication cessation in first-episode psychosis. J Psychopharmacol. 2019;33(4):532–4. https://doi.org/10.1177/0269881119827883.

Camacho-Gomez M, Castellvi P. Effectiveness of family intervention for preventing relapse in first-episode psychosis until 24 months of follow-up: a systematic review with meta-analysis of randomized controlled trials. Schizophr Bull. 2018;46(1):98–109. https://doi.org/10.1093/schbul/sbz038.

Takeuchi H, Siu C, Remington G, Fervaha G, Zipursky RB, Foussias G. Does relapse contribute to treatment resistance? Antipsychotic response in first- vs. Second-episode schizophrenia. Neuropsychopharmacology. 2018;2:1–7. https://doi.org/10.1038/s41386-018-0278-3.

Curto M, Masters G, Girardi P. Factors associated with costs of hospitalization of severely mentally ill bipolar disorder: open access factors associated with costs of hospitalization of severely mentally ill patients. J Bipolar Disord. 2016;2:1–4.

Thomas P. Relapse: causes and consequences. Encephale J. 2013;39:S79–82. https://doi.org/10.1016/S0013-7006(13)70100-3.

C-h T. One-year post-hospital medical costs and relapse rates of bipolar disorder patients in Taiwan: a population-based study. Bipolar Disord. 2010;12(8):859–65. https://doi.org/10.1111/j.1399-5618.2010.00878.

Rice S, Gleeson J, Davey C, Hetrick S, Parker A, Lederman R, et al. Original article moderated online social therapy for depression relapse prevention in young people: a pilot study of a ‘ next generation ‘ online intervention. Early Interv Psychiatry. 2018;12:613–25.

Flint AJ, Meyers BS, Rothschild AJ, Whyte EM, Alexopoulos GS, Rudorfer MV, et al. Effect of continuing olanzapine vs placebo on relapse among patients with psychotic depression in remission the STOP-PD II randomized clinical trial. JAMA Psychiatry. 2019;322(7):622–31.

Johnson S, Lamb D, Marston L, Osborn D, Mason O, Henderson C, et al. Peer-supported self-management for people discharged from a mental health crisis team: a randomized controlled trial. Lancet. 2018;392(10145):409–18. https://doi.org/10.1016/S0140-6736(18)31470-3.

Ayano G, Duko B. Relapse, and hospitalization in patients with schizophrenia and bipolar disorder at the St Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia: a comparative quantitative cross-sectional study. Neuropsychiatr Dis Treat. 2017;13:1527–31.

Habtamu K, Medhin G, Selamu M, Tirfessa K, Hanlon C. Functional impairment among people diagnosed with depression in primary healthcare in rural Ethiopia: a comparative cross-sectional study. Int J Ment Health Syst. 2019. https://doi.org/10.1186/s13033-019-0305-8.

Goleman D, Boyatzis R, Mckee A. Depression self-stigma as a mediator of the relationship between depression severity and avoidance. J Chem Inf Model. 2019;53(9):1689–99.

Girma E, Tesfaye M, Froeschl G, Möller-Leimkühler AM, Dehning S, Müller N. Facility based cross-sectional study of self-stigma among people with mental illness: towards patient empowerment approach. Int J Ment Health Syst. 2013;7(21):1–8. https://doi.org/10.1186/1752-4458-7-21.

Tanabe Y, Hayashi K, Ideno Y. The internalized stigma of mental illness (ISMI) scale: validation of the Japanese version. BMC Psychiatry. 2016. https://doi.org/10.1186/s12888-016-0825-6.

Abiola T, Udofia O, Zakari M. Psychometric properties of the 3-item Oslo social support scale among clinical students of Bayero University Kano, Nigeria. Malays J Psychiatry. 2013;22:32–41.

Group WAW. The alcohol, smoking, and substance involvement screening test (ASSIST): development, reliability and feasibility. Addict J Psychiatry. 2002;97:1183–94.

Morken G, Widen JH, Grawe RW. Rehospitalisation in recent-onset schizophrenia. BMC Psychiatry. 2008;7(8):1–7.

Arlington. Diagnostic and statistical manual of mental disorders. America; 2013, pp 153–67.

Lam DH, Watkins ER, Hayward P, Bright J, Wright K, Kerr N, et al. A randomized controlled study of cognitive therapy for relapse prevention for bipolar affective disorder. Arch Gen Psychiatry. 2003;60:145–52.

Olfson M. Cost of relapse in schizophrenia. Schizophr Bull Oxf. 1995;21(3):419–29.

Fikreyesus M, Soboka M, Feyissa GT. Psychotic relapse and associated factors among patients attending health services in Southwest Ethiopia: a cross-sectional study. BMC Psychiatry. 2016;16(354):5–7. https://doi.org/10.1186/s12888-016-1076-2.

Weret ZS, Mukherjee R. Prevalence of relapse and associated factors in patient with schizophrenia at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia: institution based cross-sectional study. Int J Interdiscip Multidiscip Stud. 2014;2(1):184–92.

Fekadu A, Kebede D, Alem A, Fekadu D, Mogga S, Negash A, et al. Clinical outcome in bipolar disorder in a community-based follow-up study in Butajira, Ethiopia. Acta Psychiatry Scand. 2006;114:426–34.

Gopinath S, Katon WJ, Russo JE, Ludman EJ. Clinical factors associated with relapse in primary care patients with chronic or recurrent depression. J Affect Disord. 2007;101(3):57–63.

Schoeler T, Petros N, Di Forti M, Klamerus E, Foglia E, Murray R, et al. Poor medication adherence and risk of relapse associated with continued cannabis use in patients with first-episode psychosis: a prospective analysis. Lancet Psychiatry. 2017;4(8):627–33. https://doi.org/10.1016/S2215-0366(17)30233-X.

Chaurotia VK, Verma KK, Baniya GC. A study of psychosocial factor related with relapse in schizophrenia. J Dent Med Sci. 2016;15(4):26–34.

Yassin S, Ali AA. Predictors of non-adherence in patients taking psychotropic medication and predictors of non-adherence in patients taking psychotropic medication and suggestions to improve. J Heal Med Nurs. 2019;38:73–5.

Hosman J-L& S. Prevention of Mental Disorders Geneva; 2005.

Wessel H, Wenaas M, Nordfjærn T. Addictive behaviors relapse after inpatient substance use treatment: a prospective cohort study among users of illicit substances. Addict Behav. 2019;90:222–8. https://doi.org/10.1016/j.addbeh.2018.11.008.

Werbeloff N, Chang C, Broadbent M, Hayes JF, Stewart R, Osborn DPJ. Admission to acute mental health services after contact with crisis resolution and home treatment teams: an investigation in two large mental health-care providers. Lancet Psychiatry. 2015;4(1):49–56. https://doi.org/10.1016/S2215-0366(16)30416-3.

Thông tin
Thông tin xuất bản

Journal of Psychosocial Rehabilitation and Mental Health

Thông tin tác giả