The role of intrusive and other recent life events on symptomatology in relapses of schizophrenia: a community nursing investigation

J Psychiatr Ment Health Nurs. 2009 Oct;16(8):685-93. doi: 10.1111/j.1365-2850.2009.01451.x.

Abstract

This study aimed to identify the impact of life events on psychotic relapse in individuals with an established diagnosis of schizophrenia to explore their proneness to experience life events, to examine if any effect of life events was cumulative or triggering in nature and to explore if specific types of events influence subsequent symptom formation. An association between adverse life events and relapse in people with schizophrenia has been reported in several studies; however, the nature of the association remains unclear. Some studies suggest that intrusive events promote the formation of paranoid psychotic symptoms. Using well-validated semi-structured interview schedules the author interviewed participants during or shortly after relapse. The severity and intrusiveness of life events was rated and relationships between events and symptoms were explored. Increasing numbers of patients experienced life events especially moderately threatening life events in the last 4 weeks prior to relapse; however, no relationship was discovered between life events in general or specifically intrusive life events and the specific content of psychotic symptoms. An increased frequency of milder life events occurred in the 2 months prior to relapse, suggesting that chronic illness is not associated with absence of mild or moderately severe life events or with diminished sensitivity to them.

MeSH terms

  • Adult
  • Age of Onset
  • Antipsychotic Agents / therapeutic use
  • Chlorpromazine / therapeutic use
  • Community Health Nursing
  • England
  • Female
  • Humans
  • Interview, Psychological
  • Life Change Events*
  • Male
  • Nursing Methodology Research
  • Psychiatric Nursing
  • Qualitative Research
  • Recurrence
  • Risk Factors
  • Schizophrenia / diagnosis
  • Schizophrenia / epidemiology*
  • Schizophrenia / prevention & control
  • Schizophrenic Psychology*
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Time Factors

Substances

  • Antipsychotic Agents
  • Chlorpromazine