Abstract:
Schizophrenia is a chronic psychiatric disorder with a modest treatment outcome. In addition,
relapses are usual. The time among relapses are rarely considered in studies. The aim of this
study was to investigate the associated factors that affect time to relapses in schizophrenic
patients at ST. Amanuel mental specialized hospital with recurrent events model in survival
analysis. To this end, data was collected retrospectively from January
, 2019 to
December
, 2020. Medical records of 332 individuals with schizophrenia were examined
covering a two-year period. Kaplan-Meier survival estimate and Log-Rank test were used to
compare the survival time. A total of 95 relapses were observed in males, and 67 relapses in
females. The median survival time of schizophrenic patients was 665 days. The parametric
proportional hazard form and parametric frailty models were used to determine the correlation
between discharge times and relapse and to identify risk factors. Model comparssion was done
using AIC, BIC and log likelihood criteria. Weibull- gamma frailty model was found to be the
best model for predicting relapse time of schizophrenic patients. The unobserved heterogeneity
in individual and correlation between relapses as estimated by the Weibull-gamma frailty model
was (p-value=0.000) and Kendall's Tau (Γ) =0.498. This indicated that there was
heterogeneity among the participants and second and subsequent relapses are likely to be
influenced by the occurrence of the first. The final model showed that the effect of comorbidity
(HR= 6.522, p-value=0.000), employment status (HR= 5.334, p-value =0.001), history of suicide
attempt (HR= 2.167, p-value=0.003) and history of traditional treatment (HR= 1.973262, p value=0.021) were significant on the hazard time to relapses. Age of onset of schizophrenia and
drug adherence was not predictive. Data indicate that, Subsequent relapses are likely dependent
on the first and previous relapses. Comorbidity, employment status, history of suicide attempt
and history of traditional treatment are important risk factors influencing hazard of time to
relapse. Clinicians should be given special attention to patients with comorbidity condition and
counseling should focus on the risk of taking a traditional treatment (treatments that does not
official).
