Outcome of first episode and relapsing patients with schizophrenia presenting to a tertiary care hospital in Sri Lanka: A prospective one year follow up study

IF 4.9 4区医学 Q1 PSYCHIATRY

Asian journal of psychiatry Pub Date : 2026-03-01 Epub Date: 2026-01-09 DOI:10.1016/j.ajp.2026.104842

Madhubhashinee Dayabandara , Prasad Liyanage , Eric Tian , Gary Remington , Varuni De Silva , Raveen Hanwella

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引用次数: 0

Abstract

Background

This study aimed to describe symptomatic and functional outcomes over 12 months for two cohorts of patients with schizophrenia in Sri Lanka.

Methodology

A prospective observational study was conducted among two cohorts of patients (first episode/FEC=122, relapsing/REC=118) aged 15–60 years diagnosed with schizophrenia in the University Psychiatry Unit, National Hospital of Sri Lanka. Patients with schizoaffective, other psychotic or organic disorders were excluded. Assessments conducted at baseline, 6 and 12 months included sociodemographic and clinical details, Positive and Negative Syndrome Scale, Centre for Epidemiological Studies Depression Scale, and WHO Psychiatric Disability Assessment Schedule. Remission followed the Remission in Schizophrenia Working Group criteria. Recovery included remission, independent living and employment.

Results

Cohorts were similar except in age distribution and substance use. Mortality was 0.8 % over 12 months. Relapse rates were similar for both cohorts (21–25 %). The FEC showed significantly higher remission (60–65 %) and recovery (45–47 %) compared with REC (remission: 38–48 %, recovery: 21–27 %) at 6- and 12-months. Sustained recovery over 12 months ranged from 13 % to 33 %. FEC presented with more severe symptoms and functional impairment at baseline but showed steeper improvement. Depression prevalence was 83 % in both cohorts at baseline. Employment significantly increased from 43 % to 53 % in FEC remaining stable for REC at 42 %. Medication non-adherence was higher in FEC (20–38 %), main reasons being forgetfulness and beliefs of non-necessity.

Conclusions

Schizophrenia outcomes remain favourable in Sri Lanka. First episode patients achieve better symptom improvement and functional gains. Early use of long-acting injectable antipsychotics, legislative reforms, psychoeducation, and family involvement may help sustain these favourable outcomes.

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斯里兰卡一家三级医院首次发作和复发精神分裂症患者的结局：一项为期一年的前瞻性随访研究

本研究旨在描述斯里兰卡两组精神分裂症患者在12个月内的症状和功能结局。方法对斯里兰卡国立医院大学精神科15-60岁确诊为精神分裂症的两组患者（首发/FEC=122，复发/REC=118）进行前瞻性观察研究。患有分裂情感性、其他精神或器质性障碍的患者被排除在外。在基线、6个月和12个月进行的评估包括社会人口学和临床细节、阳性和阴性综合征量表、流行病学研究中心抑郁量表和世卫组织精神残疾评估表。缓解遵循精神分裂症工作组的缓解标准。康复包括缓解、独立生活和就业。结果各年龄组除年龄分布和药物使用情况外，无明显差异。12个月内死亡率为0.8 %。两组患者的复发率相似（21-25 %）。FEC在6个月和12个月时的缓解率（60-65 %）和恢复率（45-47 %）明显高于REC（缓解率：38-48 %，恢复率：21-27 %）。12个月的持续回收率从13 %到33 %不等。FEC在基线时表现为更严重的症状和功能损害，但改善更迅速。基线时，两个队列的抑郁症患病率均为83% %。就业显著增加，从43 %到53 %，FEC保持稳定，为42 %。FEC的药物依从性较高（20-38 %），主要原因是遗忘和认为没有必要。结论：斯里兰卡精神分裂症患者的预后仍然良好。首发患者可获得较好的症状改善和功能改善。早期使用长效注射抗精神病药物、立法改革、心理教育和家庭参与可能有助于维持这些有利结果。

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来源期刊

Asian journal of psychiatry Medicine-Psychiatry and Mental Health

CiteScore

12.70

自引率

5.30%

发文量

297

审稿时长

35 days

期刊介绍： The Asian Journal of Psychiatry serves as a comprehensive resource for psychiatrists, mental health clinicians, neurologists, physicians, mental health students, and policymakers. Its goal is to facilitate the exchange of research findings and clinical practices between Asia and the global community. The journal focuses on psychiatric research relevant to Asia, covering preclinical, clinical, service system, and policy development topics. It also highlights the socio-cultural diversity of the region in relation to mental health.