Citation

Díaz-Fernández S, Frías-Ortiz DF, Fernández-Miranda JJ. Psychiatry Res. 2019; ePub(ePub): 112479.

Affiliation

Centro de Tratamiento Integral-AGC SM-HUCAB-SESPAsturian Mental Health Service, Gijón, Spain; Health Sciences Dt. Camilo J Cela University, Madrid, Spain. Electronic address: juanjofmiranda@gmail.com.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.psychres.2019.112479

PMID

31377009

Abstract

Lack of treatment compliance in patients with schizophrenia is a risk factor that leads to illness-relapse, hospitalization and potentially strengthens suicidal behavior. The purpose of this investigation was to assess treatment adherence, reasons for treatment discharge, suicidal behaviour and impact of route of antipsychotics administration in a group of patients with schizophrenia treated in a comprehensive, community-based, intensive case managed program for people with severe mental illness. And to compare it to previous standard treatment received in mental health units (MHU). An observational, longitudinal, mirror-image study of patients with severe schizophrenia (N = 344) was carried out: ten years of follow-up (Program) and ten years retrospective (MHU). Reasons for treatment discharge, suicide attempts and antipsychotic (AP) medication were recorded. Treatment adherence during the Program was higher than in MHU (abandonment of treatment: 12.2% vs. 84.3% of patients). Forty patients died during follow-up, five of them due to suicide. Suicidal attempts significantly decreased during Program treatment compared to the standard one (7.6% vs. 38.9% of patients). Long-acting injectable (LAI) AP medication was significantly related to this outcome. A combination of intensive case-managed and LAIAP treatment helped to improve compliance and to reduce suicidal behavior compared to standard treatment in patients with severe schizophrenia.

Copyright © 2019 Elsevier B.V. All rights reserved.

Language: en

Keywords

Antipsychotics; Case management; Clinical severity; Follow-up; Mirror-image study; Schizophrenia; Suicide; Treatment adherence