Patients with First-Episode Schizophrenia are at an Increased Risk of Nonadherence

The authors examined the risk of rehospitalization and drug discontinuation in a nationwide cohort of 2588 consecutive patients hospitalized in Finland with a first-time diagnosis of schizophrenia between 2000 and 2007. Date of prescription purchase, the Anatomical Therapeutic Chemical code of the drug, and the purchased amount stated as the number of defined daily doses were obtained from the prescription database of the Social Insurance Institution. Of 2588 patients with a first hospitalization, 1507 (58.2%) used an antipsychotic medication during the first 30 days after discharge, and 1182 (45.7% of the total) continued the initial antipsychotic medication for 30 days or longer.^{[Robinson et al., 1999]}

Another study examined relapse after response to a first episode of schizophrenia or schizoaffective disorder. Patients (N=104) were assessed on measures of psychopathologic variables, cognition, social functioning, and biological variables and were treated according to a standardized algorithm. The following rating scale criteria were used to define a relapse: at least “moderately ill” on the Clinical Global Impression (CGI) Severity of Illness Scale, “much worse” or “very much worse” on the CGI Improvement Scale, and at least “moderate” on 1 or more of the Schedule for Affective Disorders and Schizophrenia Change Version With Psychosis and Disorganization items listed above; moreover, these criteria had to be sustained for a minimum of 1 week.^{[Tiihonen et al., 2011]}

References:
Robinson D, Woerner MG, Alvir JM, et al. Predictors of relapse following response from a first episode of schizophrenia or schizoaffective disorder. Arch Gen Psychiatry. 1999; 56(3): 241-247.

Tiihonen J, Haukka J, Taylor M, Haddad PM, Patel MX, Korhonen P. A nationwide cohort study of oral and depot antipsychotics after first hospitalization for schizophrenia. Am J Psychiatry. 2011; 168(6): 603-609.