Lin Dee, Joshi Kruti, Keenan Alexander, Shepherd Jason, Bailey Hollie, Berry Mia, Wright Jack, Meakin Sophie, Benson Carmela, Kim Edward
Janssen Scientific Affairs, LLC, Titusville, NJ, United States.
Janssen Global Services, LLC, Titusville, NJ, United States.
Front Psychiatry. 2021 Oct 26;12:695672. doi: 10.3389/fpsyt.2021.695672. eCollection 2021.
To assess associations between relapses and psychosocial outcomes in adult patients with schizophrenia treated in United States (US) healthcare settings. Data were derived from a point-in-time survey of psychiatrists and their patients with schizophrenia conducted across the US, France, Spain, China, and Japan between July and October 2019. For the purposes of this analysis, only data from US practitioners and patients were included. Disease-specific programmes (DSPs) are large surveys with a validated methodology conducted in clinical practise; they describe current disease management, disease burden, and associated treatment effects (clinical and physician-perceived). Participating psychiatrists completed patient record forms for their next 10 consecutive adult consulting patients with schizophrenia, with the same patients invited to voluntarily complete a patient self-completion (PSC) questionnaire. Surveys contained questions on the patients' disease background, treatment history, prior hospitalisation due to schizophrenia relapse and a series of psychosocial outcomes. Associations between relapses in the last 12 months and psychosocial outcomes were examined using multiple regression. A total of 124 psychiatrists provided data on 1,204 patients. Of these, 469 patients (mean age, 39.6 years; 56.5% male) had known hospitalisation history for the last 12 months and completed a PSC; 116 (24.7%) patients had ≥1 relapse. Compared to patients without relapses, patients who relapsed were more likely to be homeless, unemployed, previously incarcerated, and currently have difficulties living independently (all < 0.05). Patients who experience a relapse also had greater working impairment and poorer quality of life compared with those who did not relapse. In general, psychosocial outcomes became poorer with an increasing number of relapses. In this population of patients with schizophrenia from the US, relapse was significantly associated with poor psychosocial outcomes, with a greater number of relapses predicting worse outcomes. Early intervention to reduce the risk of relapse may improve psychosocial outcomes in patients with schizophrenia.
评估美国医疗环境中成年精神分裂症患者复发与心理社会结局之间的关联。数据来自2019年7月至10月在美国、法国、西班牙、中国和日本对精神科医生及其精神分裂症患者进行的一项即时调查。出于本分析目的，仅纳入了美国从业者和患者的数据。特定疾病项目（DSPs）是在临床实践中采用经过验证的方法进行的大型调查；它们描述了当前的疾病管理、疾病负担以及相关的治疗效果（临床和医生感知的）。参与调查的精神科医生为其接下来连续10名成年精神分裂症咨询患者填写患者记录表，同样邀请这些患者自愿填写患者自填式（PSC）问卷。调查包含有关患者疾病背景、治疗史、因精神分裂症复发导致的既往住院情况以及一系列心理社会结局的问题。使用多元回归分析了过去12个月内复发与心理社会结局之间的关联。共有124名精神科医生提供了1204名患者的数据。其中，469名患者（平均年龄39.6岁；56.5%为男性）在过去12个月有已知的住院史并完成了PSC；116名（24.7%）患者有≥1次复发。与未复发的患者相比，复发的患者更有可能无家可归、失业、曾被监禁，且目前在独立生活方面存在困难（均P<0.05）。与未复发的患者相比，经历复发的患者工作受损程度更大，生活质量更差。总体而言，随着复发次数的增加，心理社会结局变得更差。在这群来自美国的精神分裂症患者中，复发与不良的心理社会结局显著相关，复发次数越多，结局越差。早期干预以降低复发风险可能会改善精神分裂症患者的心理社会结局。
