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. 2025 Oct 7;4(4):e70219.
doi: 10.1002/pcn5.70219. eCollection 2025 Dec.

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

Yoshitaka Saito  1 , Hiroyuki Muraoka  1 , Takayuki Yokoyama  1 , Katsuichiro Shimizu  1   2 , Yukihiro Tanno  1 , Nagomi Kida  1 , Taiyo Nishikawa  1   2 , Shin Miyake  1 , Yukio Kenmotsu  1 , Kosei Kamimura  1 , Hirohito Kato  1 , Yuka Noguchi  1 , Seita Tsuchida  1 , Ryutaro Suzuki  1   2   3 , Yuki Yoshimura  1 , Shoko Miura  4 , Shunsuke Kamitani  1 , Takaaki Hirooka  1 , Enami Sawayama  1 , Satoru Oishi  1   5 , Ken Inada  1
Affiliations

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

Yoshitaka Saito et al. PCN Rep. .

Abstract

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.

Keywords: polypharmacy; schizophrenia; treatment failure.

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Conflict of interest statement

Hiroyuki Muraoka has received personal fees from Eisai, Janssen, Lundbeck Japan, Takeda Pharmaceutical Company, Meiji Seika Pharma, Mochida, MSD, Otsuka, Pfizer, Viatris, and Sumitomo Pharma over the last 3 years. Satoru Oishi received personal fees from Otsuka Pharmaceutical Co., Ltd.; Meiji Seika Pharma Co., Ltd.; Astellas Pharma Inc.; Towa Pharmaceutical Co., Ltd.; Yoshitomi Pharmaceutical Industries, Ltd.; Sumitomo Pharma Co., Ltd.; Lundbeck, Japan K.K.; and Viatris Pharmaceuticals Japan Inc. Takaaki Hirooka has received personal fees from Eisai Co., Ltd., Janssen Pharmaceutical K.K., Sumitomo Pharma Co., Ltd., Takeda Pharmaceutical Company Limited, Yoshitomi Pharmaceutical Industries, Ltd., and Viatris Pharmaceuticals Japan Inc. in the last 3 years. Ken Inada received personal fees from Daiichi Sankyo, Eisai, Eli Lilly, Janssen, Lundbeck Japan, Meiji Seika Pharma, Mitsubishi Tanabe Pharma, Mochida, MSD, Nipro, Novartis, Otsuka, Pfizer, Shionogi, Sumitomo Pharma, Yoshitomiyakuhin, and Viatris, and he received research grant support from Mochida and Sumitomo Pharma. The other authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
The survival curve for the treatment failure ratio during the first year after discharge. Participants who were transferred to another hospital during outpatient visits within the 1‐year evaluation period after discharge were treated as censored cases.
Figure 2
Figure 2
The survival curves for the treatment failure ratio according to the presence or absence of antipsychotic polypharmacy. Participants who were transferred to another hospital during outpatient visits within the 1‐year evaluation period after discharge were treated as censored cases.
Figure 3
Figure 3
The survival curves for the treatment failure ratio according to the presence or absence of trial overnight stays at home during hospitalization. Participants who were transferred to another hospital during outpatient visits within the 1‐year evaluation period after discharge were treated as censored cases.
See this image and copyright information in PMC

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