Risk Factors for Relapse of Schizophrenia in the Elderly During the Maintenance Phase: A Matched Case-Control Study.

Objective: To investigate the risk factors for relapse among elderly schizophrenia patients undergoing maintenance phase treatment, aiming to offer insights for relapse prevention in this population.

Methods: A survey was conducted of elderly schizophrenia patients in the maintenance phase who attended outpatient clinics at a specialized psychiatric hospital from October, 2021 to September, 2023. The survey included both general and clinical data. Univariate analysis and multivariate non-conditional logistic regression analysis were conducted to identify independent risk factors for relapse in elderly schizophrenic patients undergoing maintenance phase treatment. A receiver operating characteristic (ROC) curve was drawn based on logistic regression results and the area under the curve (AUC) was used to evaluate the predictive value of each risk factor for relapse studied in these patients.

Results: A total of 247 patients were collected, with 225 patients included in the analysis: 75 in the recurrence group and 150 in the non-recurrence group. Multivariate logistic regression analysis indicated: Irregular medication status (odds ratio (OR) = 3.302, 95% confidence interval (CI): 1.386-7.871), low exercise frequency (OR = 2.770, 95% CI: 1.141-6.726), family care points (OR = 0.647, 95% CI: 0.514-0.813), life event points (OR = 1.353, 95% CI: 1.194-1.533), and sleep duration (OR = 0.630, 95% CI: 0.504-0.788) as independent influencing factors for relapse during the maintenance phase of elderly patients with schizophrenia. The AUC for predicting relapse varied among these factors: Medication status (AUC: 0.660, 95% CI: 0.594-0.726), exercise frequency (AUC: 0.663, 95% CI: 0.599-0.727), family care (AUC: 0.691, 95% CI: 0.618-0.764), life events (AUC: 0.792, 95% CI: 0.731-0.853), and sleep duration (AUC: 0.789, 95% CI: 0.718-0.859). When considering all influencing factors, the AUC for predicting relapse during maintenance phase treatment of elderly patients with schizophrenia was 0.908 (95% CI: 0.867-0.949).

Conclusion: Medication status, exercise frequency, family care, life events and sleep duration emerged as independent influencing factors for relapse among elderly schizophrenia patients during maintenance phase treatment. Paying attention to these influencing factors simultaneously is suggested to prevent recurrence.