Perception of risk of recurrence among patients with first episode and recurrent schizophrenia: A descriptive phenomenological study

Abstract

Abstract Background: Patients suffering from schizophrenia are at a higher risk of relapse. The perception of the risk of recurrence in patients with schizophrenia is critical for recurrence prevention. In the field of psychiatry, the study of risk perception of recurrence, has been neglected. Methods: We carried out a qualitative study using a descriptive phenomenological approach. Data were collected at twopsychiatric hospitals in China. In total, 22 patients with schizophrenia were recruited through purposive sampling. Face to face semi-structured in-depth interviews were conducted with them. Interview recordings were transcribed by the research team, and transcripts were analyzed by two independent coders with Colaizzi’s descriptive analysis framework. The consolidated criteria for reporting qualitative research checklist was used for reporting. Results: The data of first-episode schizophrenic patients yielded three themes: (i) lack of knowledge about disease recognition and medical treatment; (ii) overoptimistic estimation of the risk of recurrence; (iii) perceived importance of treatment. For first-recurrence schizophrenic patients : (i) initial awareness of relapse warning symptom; (ii) lack of systematic and accurate assessment of disease information; (iii) the perception of drug withdrawal is related to recurrence. Patients with multiple recurrences : (i) susceptibility to relapse: confusion and powerlessness; (ii) the severity of recurrence: suicidal thoughts and behavior; (iii) effects of perceived benefits and barriers on therapeutic behavior. Conclusions: In schizophrenic patients with first-episode, first-recurrence, and multiple recurrences, there were dynamic changes in the perception of disease recurrence risk and treatment behavior. Medical workers must improve risk awareness education. They should provide patients with scientific, accurate, and timely communication channels, and dynamically assess and manage the risk of recurrence in various patients.