Abstract

Schizophrenia is a disabling disease with a significant proportion of patients having more than one episode of acute psychotic symptoms. The main reason for a relapse is non-adherence, followed by age of onset. Anxiety in schizophrenia has not been thoroughly investigated; however it is clinically present in more than 40% of patients as a comorbidity.

The authors did a post-hoc analysis of a three-year prospective cohort study in a community mental health team (CMHT) in Portugal. We included all patients with the diagnosis of schizophrenia, aged 18 years and above, followed during 2015. Parametric tests (χ² test, student t test) were used for statistical analysis according to the variable type. The pharmacological treatment prescribed was screened during this period, with particular interest in the prescription of anxiolytic medication and long-acting injectable antipsychotics (LAI). We categorized the LAI available in Portugal according to the Neuroscience based Nomenclature (NbN) [1].

A total of 145 patients were selected. We found a high rate of polypharmacy. Our primary outcome was hospital admissions. Patients included in the oral antipsychotic group had fewer admissions (p-value 0.043) and a shorter duration of hospitalization (p-value 0.041). Only duration of illness (p-value <0.001) and being prescribed with anxiolytics (odds-ratio 2.8; p-value 0.015) at baseline were associated with a higher number of hospital admissions.

In the LAI group, we found a substantial prescription of different oral antipsychotics. The prescription of anxiolytics at baseline showed a negative association with hospital admissions. Larger and multicentric prospective cohorts are needed to clarify the effects of specific classes of antipsychotics in the long-term prevention of admissions, symptomatology and remission. Anxiety and anxiolytics should be further investigated in schizophrenia.