Original article

Relapse rates and associated factors in patients with schizophrenia: a retrospective study from Brcko District, Bosnia and Herzegovina

Authors

• • Sadina Osmanovic
  • • Conceptualization
    • Formal Analysis
    • Methodology
    • Writing - Original Draft
    • Writing - Review & Editing
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  • Department of Psychiatry, Health Centre Brčko District, Brčko, Bosnia and Herzegovina
• • Rusmir Softic dr.softic@gmail.com Email Rusmir Softic. (compose email, opens in email app.) Rusmir Softic ORCID profile. (opens in new tab)
  • • Conceptualization
    • Formal Analysis
    • Methodology
    • Supervision
    • Writing - Original Draft
    • Writing - Review & Editing
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  • Department of Psychiatry, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
• • Jasmina Klebic
  • • Writing - Original Draft
    • Writing - Review & Editing
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  • Public Health Centre “Dr Mustafa Šehović”, Tuzla, Bosnia and Herzegovina
• • Aida Sehanovic
  • • Writing - Review & Editing
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  • Department of Neurology, University Clinical Centre Tuzla, Bosnia and Herzegovina

Abstract

Aim: To determine the proportion of patients with recorded psychiatric rehospitalisation within one year and examine crude associations with antipsychotic treatment patterns and documented medication adherence.

Methods: This retrospective cohort study included 87 patients with International Classification of Diseases, 10th Revision schizophrenia (F20.0–F20.9) hospitalised in Brčko District during 2014–2018 and with documented 12-month follow-up. Relapse was defined as recorded psychiatric rehospitalisation due to worsening psychotic symptoms. A separate audit described discharge treatment in 236 hospitalisation records. Exact tests and crude odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.

Results: Recorded rehospitalisation occurred in 32/87 patients (36.8%). First-generation antipsychotic exposure (OR 2.11, 95% CI 0.74–6.03; p = 0.215) and antipsychotic polypharmacy (OR 2.16, 95% CI 0.82–5.65; p = 0.164) were not significantly associated with rehospitalisation. Medication non-adherence (OR 11.33, 95% CI 3.58–35.87; p < 0.001) and documented non-cooperation (OR 10.00, 95% CI 3.16–31.62; p < 0.001) showed strong crude associations. In the audit, treatment was identifiable in 183/236 records; polypharmacy was documented in 73.8% and long-acting injectable/depot use in 32.8%.

Conclusion: Documented non-adherence and non-cooperation were strongly associated with recorded rehospitalisation. The findings support structured adherence assessment and post-discharge follow-up but do not establish causal effects of antipsychotic class or regimen complexity.

Keywords: antipsychotic agents, medication adherence, patient readmission, polypharmacy, schizophrenia

How to Cite: Osmanovic, S. , Softic, R. , Klebic, J. & Sehanovic, A. (2026) “Relapse rates and associated factors in patients with schizophrenia: a retrospective study from Brcko District, Bosnia and Herzegovina”, Medicinski glasnik. 23(2). doi: https://doi.org/10.17392/medglas-2172-23-2