Association between Medication Discontinuation and Re-hospitalization in Schizophrenia Patients in Khon Kaen Rajanagarindra Psychiatric Hospital: Matched Case-Control Study

Main Article Content

Wanida Butrin
Chananya Jirapornkul
Nasamapon Handee
Naowarat Maneenin



Objectives: The study was to analyze the association between medication discontinuation and re-hospitalization in schizophrenia patients at Khon Kaen Rajanagarindra Psychiatric Hospital.

Materials and Methods: It was a matched case – control study, by using the secondary data from Electronic Medical Record of Khon Kaen Rajanagarindra Psychiatry Hospital, fiscal years 2015-2019. The study sample was 300 schizophrenic patients. The study group consisted of 150 schizophrenic patients (F20.0-F20.9) who re-hospitalized within 180 days. The control group consisted of 150 schizophrenic patients who did not re-hospitalize within 180 days. Gender and age ±2 years were matched. The association was analyzed by multivariable conditional logistic regression. The association was presented by Adjusted Odds Ratio (ORadj), 95% confidence interval.

Results: Family income, potential of caregivers, and duration of illness were controlled in the final equation, It was found that the medication discontinuation was associated with re-hospitalization among schizophrenic patients in Khon Kaen Rajanagarindra Psychiatric Hospital with statistical significance (p-value < 0.05). The patients with medication discontinuation were 2.0 times more likely to re-hospitalize than those with medication continuation (OR adj = 2.0, 95%CI; 1.15 - 3.47) (p=0.013).

Conclusion: Medication discontinuation was associated with re-hospitalization in schizophrenic patients in Khon Kaen Rajanagarindra Psychiatric Hospital.


Download data is not yet available.

Article Details

Original article (นิพนธ์ต้นฉบับ)


Kittiratanapaiboon P, Silpakit P. Systematic innovation development work plan for the creation mental health enhancement. Chiang Mai: Suanprung Psychiatric Hospital; 2017. (in Thai)

World Health Organization (WHO). The world health statistics 2016: monitoring health for the SDGs. Geneva: WHO; 2016.

Keepers GA, Fochtmann LJ, Anzia JM, Benjamin S, Lyness JM, Mojtabai R, et al. The American Psychiatric Association practice guideline for the treatment of patients with schizophrenia. Am J Psychiatry [Internet]. 2020 [cited 2021 Jun 15];177:868-72. Available from:

Kittiratanapaiboon P, Tantirangsi N, Jutha W, Tanari A, Kwansanit P, Asanangkonchai S, et al. Psychiatric disorders and mental health problems: Thai mental health survey 2013. Nonthaburi: Department of Mental Health; 2016. (in Thai)

Ministry of Public Health. Department of Mental Health. Training participants' guide to accessing psychotic services and caring for mental illnesses for nurses/public health scholars. 5th rev.ed. Bangkok: Deena Media Plus; 2019. (in Thai)

Suttachit S. Common comorbid conditions in schizophrenia patients. Chiang Mai: Department of Psychology. Faculty of Medicine Chiang Mai University; 2017. (in Thai)

The World Health Organization. Schizophrenia [Internet]. 2019 [cited 2012 Jun 15]. Available from:

Millier A, Sarlon E, Azorin JM, Boyer L, Aballea S, Auquier P, et al. Relapse according to antipsychotic treatment in schizophrenic patients: a propensity -adjusted analysis. BMC Psychiatry [Internet]. 2011 [cited 2021 Jun 2];24:[about 9 screens]. Available from:

Olivares MJ, Thirunavukarasu M, Kulkarni J, Zhang HY, Zhang M, Zhang F. Psychiatrists’ awareness of partial and nonadherence to antipsychotic medication in schizophrenia: results from an Asia-Pacific survey. Neuropsychiatry Dis Treat 2013;9:1163-70. doi: 10.2147/NDT.S49080. [Epub 2013 Aug 12]

Hui CLM, Honor WG, Lee EHM, Chang WC, Chan SKW, Chen ESM, et al. Long-term effects of discontinuation from antipsychotic maintenance following first-episode schizophrenia and related disorders: a 10 year follow-up of a randomised, double-blind trial. Lancet Psychiatry 2018;5:432-42. doi: 10.1016/S2215-0366(18)30090-7. [Epub 2018 Mar 15]

The National institute of Mental Health [Internet]. 2020. Retrieved from schizophrenia. Available from:

Kwansanit P, Srisurapanon M. An epidemiological measure to calculate the burden of schizophrenia in Thailand. J Mental Health of Thailand 2018;26:50-62. (in Thai)

Phanthunane P, Vos T, Whiteford H, Bertram M, Udomratn P. Schizophrenia in Thailand: prevalence and burden of disease. Popul Health Metr 2010;8:24. doi: 10. 1186/1478-7954-8-24.

Chi MH, Hsiao CY, Chen KC, Lee LT, Tsai HC, Lee IH, et al. The readmission rate and medical cost of patients with schizophrenia after first hospitalization – a 10-year follow up population-base study. Schizophr Res 2016;170:184-90. doi: 10.1016/j. schres.2015.11.025. [Epub 2015 Dec 8]

Üçok A, Kara IA. Relapse rates following antipsychotic discontinuation in the maintenance phase after first-episode of schizophrenia: results of a long-term follow-up study. Schizophr Res 2020;225:31-8. doi: 10.1016/j.schres.2019.10.015. [Epub 2019 Oct 22]

Chainu K, Thongsuk K, Phuhongthong M. Factors affecting relapse in patients with chronic schizophrenia, Ban Phai District, Khon Kaen Province. J Khon Kaen Provincial Public Health Office. 2019;1:16-24. (in Thai)

Bernardo M, Canas F, Herrera B, Dorado MG. Adherence predicts symptomatic and psychosocial remission in schizophrenia: naturalistic study of patient integration in the community. Rev Psiquiatr Salud Ment. 2017;10:149-59. doi: 10.1016/j.rpsm.2016 .04.001. [Epub 2016 Jun 10]