Prevalence and Biopsychosocial Factors Associated with Relapse in Patients with First-Episode Schizophrenia in a Clinical Setting in Southern Thailand

Objective: This study aimed to assess the prevalence of relapse among patients with first-episode schizophrenia and identify its associated biopsychosocial factors. Materials and Methods: This was a cross-sectional study conducted at a major psychiatric hospital in southern Thailand. This study included patients aged 18-59 years diagnosed with schizophrenia within the preceding 3 years. Data were collected using a demographic questionnaire and five standardized instruments. Descriptive statistics and univariate and multivariate logistic regression analyses were performed to identify factors associated with relapse. Results: A total of 220 patients were included in this study. The prevalence of relapse was 21.8%. The univariate analysis revealed that medication adherence, coping strategies, social support, substance use (p < .01), and cognitive insight (p < .05) were significantly associated with relapse. In the multivariate logistic regression analysis, medication adherence and coping strategies remained independently associated with relapse. Particularly, each one-unit increase in medication adherence was associated with a 71% decrease in the risk of relapse (odds ratio [OR] = 0.29, 95% confidence interval [CI] = 0.12-0.31, p < .01). Similarly, each one-unit increase in the coping strategy score was associated with a 20% decrease in the risk of relapse (OR = 0.80, 95% CI = 0.67-0.94, p < .01). Conclusion: Higher levels of medication adherence and greater use of coping strategies were associated with a decreased risk of relapse. Healthcare professionals should promote medication adherence and strengthen coping skills among patients with first-episode schizophrenia to enhance long-term stability and successful community functioning.