Clinical and demographic factors associated with early relapse in patients with schizophrenia: a naturalistic observation study.

Schizophrenia is a chronic psychiatric disorder progressing in relapses. Identification of many factors that may potentially increase the risk of relapse will be an important step in preventing relapses. The aim of this study was to determine the rate of early relapse in patients with schizophrenia and possible risk factors related to early relapse. The sample of this prospective study with the naturalistic observation design consisted of 308 patients with schizophrenia. The cutoff value for early relapse was determined as 1 year. The mean age of participants was 37.38 ± 12.28 years and 66.6% of them were male (n = 205). The early relapse rate was 38.3%. The age younger than 35 [hazard ratio (HR) = 2.313; 95% confidence interval (CI), 1.518-3.526; P < 0.001], use of psychoactive substance (HR = 2.200; 95% CI, 1.407-3.440; P = 0.001), previous attempt of suicide (HR = 1.565; 95% CI, 1.028-2.384; P = 0.037), bad adherence to treatment (HR = 3.102; 95% CI, 1.358-7.086; P = 0.007), long-acting injectables (LAIs) antipsychotics in the treatment (HR = 0.534; 95% CI, 0.351-0.812; P = 0.003), combination typical-atypical antipsychotics (HR = 0.326; 95% CI, 0.131-0.807; P = 0.015), number of episodes (HR = 1.088; 95% CI, 1.043-1.134), and the score on the Side Effect factor of the Clinical Global Impressions Scale (HR = 1.826; 95% CI, 1.357-2.458; P < 0.001) were identified as the independent predictors of early relapse. It is remarkable that treatment bad adherence, use of psychoactive substance, no LAIs antipsychotics included in the treatment, and the no presence of the combination of typical and atypical antipsychotics are alterable predictors of early relapse.

The comparison of anxiety, depression and stress symptoms levels of healthcare workers between the first and second COVID-19 peaks.

BACKGROUNDS: Although the psychological effects of the COVID-19 pandemic have been investigated, there is no study comparing the effects between the peaks. This study aims to compare the levels of anxiety, depression, and stress of healthcare workers struggling with pandemic between the first and second peaks. METHODS: A total of 2460 healthcare workers, 1051 from the first peak period and 1409 from the second peak period, were included in the study. The first peak measurements of the participants were made between 07.04.2020 and 05.05.2020 and the second peak measurements were made between 22.11.2020 and 20.12.2020 according to the peak period in Turkey. Depression-Anxiety-Stress-21(DASS-21) scale was applied to the participants online by the purpose of the study. RESULTS: The mean age of the participants was 32.63 ± 7.70, and 66.5% of them were female. A statistically significant difference was found between the income status (p < 0.001), lifestyle (p < 0.001) and COVID-19 test result (p < 0.001), DASS-21 Depression (p < 0.001, t = -5.311), Anxiety (p < 0.001, t = -8.244), Stress (p < 0.001, -10.056) and total(p < 0.001, t = -8.719) scores of the two groups. CONCLUSION: The present study results showed that healthcare workers meticulously struggling with the pandemic had increased anxiety, depression, and stress levels at the second peak of the pandemic compared to the first peak.