Patients with Schizophrenia who Attended a Partial Hospitalization Program of Psychiatry at Médio Tejo Hospital Center: A Descriptive Study

Abstract

Introduction: The aim is to evaluate a clinical series of patients with schizophrenia who attended a Partial Hospitalization Program of Psychiatry, in order to understand what challenges these patients pose to us in terms of their treatment, relapse prevention and social reintegration.
Methods: We analyzed a cohort of patients diagnosed with schizophrenia, who attended the Partial Hospitalization Program at a Department of Psychiatry, between the years 2016 and 2020. Data was extracted regarding sociodemographic characterization, attendance of the program, pharmacological treatment, comorbidities, readmissions to the acute ward, post‑discharge social responses and presence of psychotic symptoms.
Results: Thirty three patients were included. Most of them were male (66.67%), with an average age of 35.09 years, mostly coming from Tomar (51.52%) and living with their parents and/or siblings (75.76%). 42.42% were initially unemployed. Patients attended partial hospitalization for an average of 68.71 months. Regarding pharmacological treatment, clozapine established itself as the most common oral antipsychotic and paliperidone as the most common injectable antipsychotic. The average number of antipsychotic medications per patient increased over time accompanied by a significant increase in injectable antipsychotic medications, and a slight decrease in the number of oral antipsychotics. There is also a decrease in the utilization of benzodiazepines, but the utilization of medications to treat extrapyramidal and depressive symptoms remains high. The most frequent medical comorbidity after discharge is overweight/obesity in 30.3% of cases. Acute ward admissions dropped significantly. Regarding post‑discharge social responses, unemployment declined significantly; protected jobs and disability pensions increased significantly. Regarding psychotic symptoms, the number of patients presenting with negative and cognitive symptoms remained high at discharge from the program.
Conclusion: The Partial Hospitalization Program seems to translate in the long term into a smaller number of readmissions in the acute ward. It also contributes to improving the social reintegration of the patients. However, the stability of these patients is mostly achieved through a high cumulative dose of antipsychotic medication. These patients present with significant medical comorbidities and a progressive increase in polypharmacy throughout the years, showing us that we still have a long way to go when it comes to treating patients with schizophrenia.