Schizophrenia "High Recurrence", The Main Reason Is That Patients Stop The Drug By Themselves!
Schizophrenia is a chronic and serious mental disorder, and high recurrence is the main problem and challenge in the treatment of this disease. Data show that the recurrence rate of patients with schizophrenia one year after discharge is about 40%. Interruption of drug treatment is the main reason for the recurrence of schizophrenia. The recurrence rate of patients with discontinuation within one year is as high as 77%.
There are data showing that the recurrence rate of patients with schizophrenia one year after discharge is about 40%. Interruption of drug treatment is the main reason for the recurrence of schizophrenia. The recurrence rate of patients with drug withdrawal within one year is as high as 77%.
On August 8, the "Spirit of Goodness-Bethune National Mental Health Symposium" sponsored by Bethune Charity Foundation was held in Guangzhou, focusing on the 2020 mental health policy and work priorities, local mental health medical security work experience, and psychiatric hospitals Internet + medical and health practice experience, mental health poverty alleviation cases, mental illness innovative hospital-community integrated treatment model, etc. are discussed.
Experts at the meeting said that to strengthen the treatment and management of patients with severe mental disorders, receiving full-course, systematic and long-term treatment is essential to maintain the stability of patients with schizophrenia. Experts at the conference unanimously called for the promotion of an integrated hospital-community treatment model for patients with mental disorders, and the use of long-term treatment plans to improve patient compliance, thereby reducing disease recurrence rate, helping patients adapt and returning to society, and reducing the risk of extreme violent events caused by illness.
Recommendation:
From taking medicine every day to one injection every month, patient compliance improves
Take medicine if you are sick. This simple principle is placed on patients with schizophrenia, and it is quite difficult to implement. Currently commonly used oral medications, patients with schizophrenia generally have poor compliance. More than half of the patients give up their doctor's orders within 30 days of discharge, or even stop the medication by themselves.
According to Xiao Yaonan, vice president of the Third People’s Hospital of Yunfu City (Luoding) and director of the Mental Health Center of Luoding City, there are currently more than 19,000 patients with severe mental disorders registered in Yunfu City, with a detection rate of 7.7‰, most of which are Patients with schizophrenia.
Li Hao (pseudonym) is one of more than 12,000 patients with schizophrenia registered locally. After being diagnosed with the disease, he embarked on a long journey of medication treatment. Like many patients, he was unwilling to admit that he was sick, and became irritable when he heard his father call to take medicine. Father often coaxed and even used threats, but he had to take medicine every day, and some medicine had to be taken twice a day. Li Hao always had a way to stop the medicine secretly. Because of poor medication compliance, Li Hao was hospitalized repeatedly.
Especially during the outbreak of new coronary pneumonia, patients with mental disorders have to stop treatment due to difficulty in seeing a doctor and getting medicine, and the risk increases. In order to further strengthen the management of mental disorder treatment and psychosocial services, Guangdong Yunfu launched the "long-term monitoring and stable return" three-year campaign, implemented free long-acting injections, opened primary psychiatric clinics, and strengthened information construction.
For patients with schizophrenia who have poor treatment compliance, weak family monitoring capabilities or no monitoring, and risk of causing accidents, Yunfu City adopts "medical insurance reimbursement + financial assistance", "all levels of psychiatric outpatient injection and household injection simultaneously", " Strong measures such as the hierarchical advancement of risk assessment levels have become the first prefecture-level city in the province to comprehensively formulate policies and implement the second-generation long-acting injections.
"For patients with schizophrenia without contraindications, we also recommend long-acting injections." Xiao Yaonan said that as of August 8, 2020, Yunfu City has used long-acting injections for 1,100 patients, and it is planned that the number of injections will increase by the end of this year. To 2000.
Li Hao is one of the first beneficiaries of Yunfu's free long-acting injections. At present, he is mainly given injections, only one injection per month, which saves a lot of trouble. Now, he insists on treatment, not only returning to a normal life, but also helping the family with work.
Since 2013, Yunfu City has opened psychiatric clinics in 63 township health centers/community health service centers, with a total of 76 psychiatrists. The psychiatric clinics are equipped with at least 30 kinds of psychiatric drugs. Registered patients with severe mental disorders treated in psychiatric outpatient clinics receive free treatment, and the government will cover them after medical insurance is reimbursed.
530,000 people in Guangdong suffer from severe mental disorders, and nearly 70% are schizophrenia
Severe mental disorders are mainly six types of disorders, which are schizophrenia, bipolar disorder, schizoaffective disorder, paranoid mental disorder, mental disorder caused by epilepsy, and mental disorder with developmental delay.
Global data show that the prevalence of schizophrenia is 1%, which means that about one schizophrenic patient in 100 people. In China, the prevalence of severe mental disorders is 1%, and the prevalence of schizophrenia is about 0.6%. It can be estimated that among the 115 million people in Guangdong, approximately 1.15 million suffer from severe mental disorders, but only 530,000 are registered, of which 65% are schizophrenia.
Professor Jia Fujun, director of the Guangdong Provincial Mental Health Center, said that from a global perspective, the burden of mental disorders ranks first in the total disease burden, surpassing cardiovascular and cerebrovascular diseases, respiratory diseases, malignant tumors and other diseases. The disease not only has a serious impact on the work and life of patients, but also brings a heavy burden to the family and society.
In recent years, Guangdong has continuously increased its emphasis on mental illness, promoted the integrated treatment model of community treatment in mental disorder hospitals, and implemented "treatment of severe illness in the hospital, and rehabilitation management in the community."
Professor Lin Yongqiang, chief physician of the Department of Psychiatry, Department of Public Health, Guangdong Mental Health Center, pointed out that the community is an important place for patients with mental illness to live and treat after being discharged from the hospital, but community mental health services have always been a relatively weak link.
"For mental patients, many people think that they just need to see a doctor and be hospitalized, and ignore the rehabilitation and management of the patient. In fact, it is very necessary to use the mental health center as the hub to connect the hospital and the community." He said that only community services continue to develop and improve Only when community rehabilitation and hospital treatment are effectively connected can continuous and comprehensive services be truly realized.
Yunfu attaches great importance to the treatment and management of patients with mental disorders. It is the first prefecture-level city in the province and even the whole country to have a psychiatrist in every township health center. In addition, limited funds can be used to ensure the regular medication rate and the stable rate of treatment for patients with mental disorders. Patients with severe mental disorders mainly rely on medication to control them. Interrupting medication can easily relapse. Long-acting injection therapy can ensure that patients continue to take medication and maintain the blood concentration for a month or more. When the condition is stable, the recurrence rate will naturally decrease. In addition, violent and wounding incidents caused by mental illness will also be reduced, and ultimately benefit patients, families, and society.
Recommendation:
The American Psychiatric Association Publishing Textbook of Schizophrenia
