Anxiety, older age linked to rehospitalization among patients with schizophrenia

Anxiety level and older age appeared to be associated with rehospitalization among patients with schizophrenia, according to results of a retrospective observational study conducted in Japan and published in Psychiatric Annals.

“Short-term rehospitalization, termed the ‘revolving door’ phenomenon, is a common event in patients with schizophrenia,” Narimasa Katsuta, MD, PhD, associate professor of the department of psychiatry at Juntendo University, and colleagues wrote. “Thus, preventing relapses of schizophrenic episodes is important to improve prognoses, avert deterioration in social, occupational and financial status, and avoid the increased burden of familial care. Although the use of monotherapy with second-generation antipsychotics (SGAs) has recently become widely accepted in Japan, the prescription of first-generation antipsychotics (FGAs) and/or polypharmacy for patients with schizophrenia remains common.”

Although SGAs are more effective at reducing negative symptoms and are associated with fewer extrapyramidal symptoms compared with FGAs, SGAs have been linked to metabolic-related side effects, including weight gain. Katsuta and colleagues aimed to investigate the relationship between rehospitalization rates and types of antipsychotics administered in light of multiple other clinical factors. The investigators retrospectively reviewed medical records of 92 Japanese patients with acute stage schizophrenia who were admitted to one of two hospitals between April 2012 and March 2014.

Univariate analysis revealed no significant differences in types of antipsychotics administered among patients who were vs. who were not rehospitalized. Those who were rehospitalized were significantly older and had longer illness durations, as well as significantly increased total scores on the Brief Psychiatric Rating Scale; however, only the score for the item “anxiety” was significantly greater at the time of rehospitalization vs. at last discharge.

“The availability of community-based mental health treatment for patients after discharge, including assertive community treatment, remains insufficient in Japan,” Katsuta and colleagues wrote. “It is also desirable to use community resources and educational institutions to support patients with schizophrenia in reducing and preventing recurrence.”