Prevalence and Factors Associated With Relapse in Individuals With Psychotic Disorders Attending Psychiatric Outpatient Clinic at Muhimbili National Hospital, Tanzania

Abstract

Background: Relapse is a challenging characteristic of Psychotic Disorders for any clinician. It potentiates a decline in functioning and hinders recovery. Many factors, such as the early onset of psychosis, lack of social support, substance use, and poor adherence to medications, have been identified as enhancing relapse. This study aimed to determine the prevalence and biopsychosocial factors associated with relapse among individuals with Psychotic Disorders attending the Psychiatric Outpatient Clinic at Muhimbili National Hospital (MNH), Dar Es Salaam, Tanzania.
Methods: This is a hospital-based cross-sectional analytical study. A consecutive sampling technique was used to enroll 314 individuals with diagnoses of Psychotic Disorders at the Psychiatric Outpatient Clinic of MNH. The data was collected from October to November 2024 using a semi-structured questionnaire. Life Events Survey Modified Version (LES-MV) captured the participants’ stressful life events. The OSLO Social Support Scale-3 (OSSS-3) assessed the perceived social support. Relapse was captured based on the rehospitalization criterion. Data analysis was conducted using STATA version 18, including bivariate and multivariable regression analyses. A P-value<5% was statistically significant.
Results: A total of 282 participants’ questionnaires were analyzed. Their ages (in years) ranged from 18 to 86 (Mean: 39.4±13.8). One hundred thirty-eight (48.9%) had a psychosis onset before 25 years. One hundred thirty-four (47.5%) had a history of substance use. Only forty-six (16.3%) had strong social support. The proportion with at least one relapse was 74.7%. Relapse was associated with early onset psychosis (Late onset: AOR=0.28; 95%CI: 0.06-0.98; P<.05), poor social support (strong social support: AOR=0.07; 95%CI: 0.03-0.17;P<.01), and substance use (AOR=2.80; 95%CI: 2.21-6.47; P<.05).
Conclusion: The findings of this study revealed a high prevalence of relapse among persons diagnosed with Psychotic Disorders, highlighting the need for enhancement of ability to use the monitoring tools for psychosis, and advocating for social support and substance use prevention among individuals with Psychotic Disorders.