A large review article recently published in Nature has revealed some perhaps long-suspected information about people living with schizophrenia and schizoaffective disorder who tend to relapse.
The authors’ methods in this study tried something a little different. Instead of relying on insurance claims data or only using small populations, they searched a system of large electronic health records (EHRs) to analyze the relationships between relapse episodes and characteristics such as race, disease, insurance status, and more. The data, which included 8119 patients, came from October 15, 2016, to December 31, 2021, and focused on patients who received care for at least 12 months.
What they defined as relapse was an emergency room visit or an inpatient hospitalization for their condition. Of the total patients in the study, 30.52 percent experienced a relapse, while 69.48 percent experienced no relapse. The patients were primarily male and accounted for 54.72 percent of the demographic, while 54.23 percent were white non-Hispanic or Latino.
Even though the patient population consisted mostly of white males, the study showed that those who were more likely to relapse were more likely to be Black (34.68 percent of Blacks), other Pacific Islander (58.33 percent of other Pacific Islanders), and Latino (35.36 percent of Latinos) compared to whites.
Those who relapsed also were more likely to be under Medicaid or Medicare, with a 33 percent and 22 percent increased prevalence, respectively. They were more likely, at a 33 percent increased prevalence, to have a diagnosis of substance abuse alongside their diagnosis of schizophrenia and schizoaffective disorder. They also were more likely to have more encounters with health care, indicating that those who frequent hospitals are more likely to visit them again.
These patients are more likely to be prescribed more medications than those who did not relapse, and the most common prescription written tends to be for atypical antipsychotics when typical antipsychotics haven’t worked.
Oddly, patients who relapsed were less likely to have diagnoses of obesity, hypertension, and diabetes. There were no sex differences in the likelihood of relapse episodes.
In a literature review that included 145 other manuscripts, similar factors were observed for determining who was more at risk for relapse.
The most common factors were nonadherence to treatments like medications, stress and depression, and substance use. Those who were more likely to relapse were also less likely to be privately insured, which may imply that those who cannot work or gain private insurance through other means like family members or spouses are more likely to relapse.
What this study confirms is an instinct many who work in the industry perhaps have already observed. Those who are more at risk for relapse episodes need more targeted treatment solutions so that people living with schizophrenia and schizoaffective disorder can reduce their interaction with substance abuse and increase their adherence to prescribed treatments.
References
Rivelli, A., Fitzpatrick, V., Nelson, M., Laubmeier, K., Zeni, C., & Mylavarapu, S. (2024). Real-world predictors of relapse in patients with schizophrenia and schizoaffective disorder in a large health system. Schizophrenia, 10(1), 28.
Who Relapses From Schizophrenia?
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A large review article recently published in Nature has revealed some perhaps long-suspected information about people living with schizophrenia and schizoaffective disorder who tend to relapse.
The authors’ methods in this study tried something a little different. Instead of relying on insurance claims data or only using small populations, they searched a system of large electronic health records (EHRs) to analyze the relationships between relapse episodes and characteristics such as race, disease, insurance status, and more. The data, which included 8119 patients, came from October 15, 2016, to December 31, 2021, and focused on patients who received care for at least 12 months.
What they defined as relapse was an emergency room visit or an inpatient hospitalization for their condition. Of the total patients in the study, 30.52........
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