The effects of soci̇al envi̇ronment on relapses i̇n schi̇zophreni̇a and other psychoti̇c di̇sorders

THE EFFECTS OF SOCİAL ENVİRONMENT ON RELAPSES İN SCHİZOPHRENİA AND OTHER PSYCHOTİC DİSORDERS Dr Burcu ÜNAL Dokuz Eylul University Faculty of Medicine Department of Psychiatry dr.burcu.unal@gmail.com Supervisor: Prof. Dr. Berna Binnur AKDEDE ABSTRACT Objective: There is a large body of literature about the relationship between social environment and the prevalence and incidence of schizophrenia and other psychotic disorders. But therese is limited data abaout the effects of social environment on the prognosis and relapses of these disorders. Moreover a related subject social capital is a new growing area. The criteria of relapses in schizophrenia is not well described. In this study we aimed to investigate the effects of the social environment on relapses of schizophrenia and other psychotic disorders. Method: This is a retrospective prospektif study. We included 147 patients with the diagnosis of schizophrenia (112) or other psychotic (35) disorders. We obtained the residential history (neighbourhood and residential mobility), the history of relapses and other prognostic features (such as hospitalization, antipsychotic drup doses) from January 2009 to December 2013 retrospectively, by surveying the hospital case registry data and with the interviews with patients. We described the social capital, voting partipication (linking social capital )and socioeconomic deprivation, of neihbourhoods, as social environment. We investigate the relationship between social environmet and prognosis and relapses. Results: We couldn't find a relationship between social environment and relapses. But there was a relationship between residential mobility and history of relapses. The group with the history of relaps had significantly more residental mobility according to the group with no relapse. The history of relapses were associated with higher doses of antipsychotics. The group with the history of relaps was younger than the group with no relapse. The association between age and relaps remained after adjustment for age, sex and level of education, as confounding factors. Conclusion: We couldn't find a relationship between neighbourhood social environment and relapses. Residential mobility was assiciated with relaps, and this relationship was stronger when the residing in the same addres was shorter. History of relapses is associated with and higher doses usage of antipsychotics. Younger age was associated with relapse. İt is difficult to term and estimate of social environment, as a new growing area in the literature and we need more researches to determine the effect of social environment on pshychosis.. Key words: schizophrenia, psychotic disorders, social environment , social capital, relapse