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

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.