A Study on Precipitating Factors in Patients with Schizophrenia in Krabi Province, Thailand
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Abstract
Objective: The objectives of this study are to analyze precipitating factors of schizophrenia at Krabi Hospital and compare related factors between patients with symptom-free periods exceeding five years and those with recent symptoms. The findings will help improve schizophrenia care in Krabi Province, promoting long-term stability.
Methods: Data were collected from schizophrenia patients receiving treatment at the psychiatry department of Krabi Hospital and analyzed using descriptive statistics, presented as percentages. For inferential statistics, Chi-square tests and Odds Ratios (OR) were applied. Single-variable analyses were conducted to identify variables with a P-value < 0.25 for further analysis using multiple logistic regression, with adjusted odds ratios and 95% confidence intervals.
Results: Patients who have never used amphetamines are 3.004 times more likely (adjusted OR = 3.004) than former users to have had their last episode over five years ago. Those in prisons or Islamic boarding schools (Pondoks) are the least likely to remain episode-free for over five years, with symptoms recurring within the past five years. Patients with underlying medical conditions are 2.49 times more likely (adjusted OR = 2.49) than those without to have had their last episode over five years ago. Substance use is the most common trigger for recent schizophrenia episodes. In patients who have experienced two or more episodes, where the most recent episode was triggered by substance use, some continued using the same substance, increased or reduced usage, switched substances, or had no substance use in the previous episode. Some who were previously triggered by substance use abstained in the latest episode. Individuals in daily wage labor have significantly higher odds of symptom remission than those in Pondoks or prisons (adjusted OR = 13.41).
Conclusion: Factors associated with the absence of symptoms for more than five years include never using amphetamines, having underlying conditions, and working in labor-related jobs. Those with medical conditions may prioritize health, ensuring consistent treatment and prolonged remission. Similarly, employed individuals are more likely to maintain remission. Promoting employment may enhance mental well-being and stability. Conversely, those in Pondoks or prisons face a higher risk of symptoms within five years, often due to relapse, criminal offenses, or substance use, leading to rehabilitation or incarceration. However, these institutions can also facilitate treatment access. Strengthening healthcare collaboration with them could improve patient care.
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