Factors associated with treatment failure after discharge in inpatients with schizophrenia spectrum disorders: A retrospective observational study.

Aim: Schizophrenia spectrum disorders are among the most serious mental illnesses that cause social dysfunction. Patients with schizophrenia spectrum disorders are prone to recurrence, and those who require hospitalization are at a high risk; hence, preventing treatment failure after discharge is essential. Therefore, we conducted a retrospective study to identify the factors associated with treatment failure after discharge in patients with schizophrenia spectrum disorders who received psychiatric inpatient treatment. Methods: This study included 859 patients diagnosed with schizophrenia spectrum and other psychotic disorders who were hospitalized at the Department of Psychiatry in Kitasato University Hospital and Kitasato University East Hospital from January 1, 2014, to December 31, 2021. Treatment failure was defined as discontinuation of outpatient care, psychiatric hospitalization, or death within 1 year after discharge. Results: Of the 859 patients, 201 (23.4%) experienced treatment failure. Treatment failure rate was 29.0% in patients undergoing antipsychotic polypharmacy, significantly higher than that in patients who were not. Additionally, treatment failure was 20.8% in patients who had a trial overnight stay at home during hospitalization, significantly lower than that in patients who did not. Conclusion: Antipsychotic polypharmacy at discharge was associated with treatment failure in patients with schizophrenia spectrum disorders. Additionally, trial overnight stays at home during hospitalization potentially contributed to preventing treatment failure. Therefore, preventing treatment failure in patients with schizophrenia spectrum disorder requires optimizing pharmacotherapy and implementing social and environmental adjustments, focusing on the post-discharge period.