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Prevalence and predictors of treatment-resistant schizophrenia in a tertiary hospital in Northeast Brazil.

  • Soares, Douglas de Sousa1
  • Carvalho, Danyelle Rolim1
  • Ribeiro, Mellanie Dellylah Trinta1
  • Diniz, Elton Jorge Bessa2
  • Rêgo, Alcides Ferreira Neto1
  • 1 Programa de Residência Médica em Psiquiatria, Hospital de Saúde Mental Professor Frota Pinto, Fortaleza, CE, Brazil. , (Brazil)
  • 2 Programa de Esquizofrenia (PROESQ), Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil. Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, UNIFESP, São Paulo, SP, Brazil. , (Brazil)
Published Article
Trends in psychiatry and psychotherapy
Publication Date
Jun 15, 2021
DOI: 10.47626/2237-6089-2020-0151
PMID: 34139114


To investigate epidemiological factors related to treatment-resistant schizophrenia (TRS) in Northeast Brazil, a region where data about mental health are still scarce. This retrospective cross-sectional study included all patients with schizophrenia currently receiving treatment at the outpatient psychiatric clinic of a tertiary hospital in Northeast Brazil. They were divided into TRS and treatment-responsive groups, and epidemiological characteristics of both groups were compared. A logistic regression model investigated factors related to treatment resistance. Two hundred and five patients were included, 155 treatment-resistant and 50 treatment-responsive. The TRS group had higher use of benzodiazepines (36.1 vs. 18%, p = 0.017) and antiepileptics (36.8 vs. 8.0%, p < 0.001), antipsychotic polypharmacy (28.6 vs. 8%, p = 0.003) and suicide attempts (35.6 vs. 20%, p = 0.04). Age at onset was younger (19.7±7.3 vs. 24.6±8.6 years, p = 0.001) and CGI was higher in TRS (3.72±1.00 vs. 3.16±1.00, p = 0.001). In logistic regression, being married was a protector (odds ratio [OR] = 0.248, 95% confidence interval [95%CI] 0.091-0.679, p = 0.007) and younger age at onset was a predictor (OR = 1.076, 95%CI 1.034-1.120, p < 0.001) of treatment resistance. Early onset of disease was associated with more treatment resistance, while being married with less resistance. Clinicians should identify early predictors of resistance in order to reduce unfavorable outcomes.

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