Relapse and Contributing Factors in Schizophrenia Spectrum Disorders: A Study at Muhimbili National Hospital, Tanzania

Abstract

Background and Aims: Relapse in patients with Schizophrenia Spectrum Disorder often worsens clinical outcomes. This study examines sociodemographic factors alongside other variables, including follow-up frequency, illness duration, stigma, perceived stress, perceived criticism, and social support, to explore their potential contributions to relapse among patients with schizophrenia at Muhimbili National Hospital, Tanzania. Methods: It was a cross-sectional study involved non-probabilistic sampling of patients attending psychiatric clinics at Muhimbili National Hospital, Tanzania. Data were collected through semi-structured questionnaires including Internalized Stigma of Mental Illness Inventory (ISMI), Medication Adherence Rating Scale (MARS), and Oslo Social Support Scale (OSSS-3). Statistical analysis, including odds ratios, chi-square, T-tests, and correlations, was conducted using SPSS-23, with significance determined at p< 0.05. Results: The study included 100 patients, with 54% male (n=54). Nearly half (49%) were aged 18–39 years, and 63% (n=63) were single. Relapse was significantly associated with younger individuals (p= 0.001), single or divorced (p= 0.001), irregular follow-up (p= 0.003) and shorter illness durations (p= 0.001). Other factors including high stigma (p= 0.027), perceived criticism (p= 0.001), stress (p= 0.015), and poor medication adherence (p= 0.001), and unemployment (p= 0.035), also contributed to increased relapse rates. Conclusion: High stigma, criticism, stress, and poor medication adherence contribute to schizophrenia relapse. The study recommends offering interventions that address clinical and psychosocial factors, including improving social support, reducing stigma, and ensuring access to affordable medications. Further research with a larger sample size and broader inclusion of hospitals and geographic areas is recommended to enhance results generalizability.

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