Relapses are common and a higher number of relapses involve a greater cognitive impairment of the patient. Prevention of relapses is therefore the primary objective of treatment.

To establish why a sample of patients with schizophrenia experience relapses and are admitted to acute units as a result.

A multicenter, naturalistic, retrospective study assessing medical intervention in 1346 patients with schizophrenia admitted to acute units in Spain, assessing the following causes of relapses: non-compliance, lack of efficacy, drug abuse, stress and high incidence of side effects.

90.8% of patients were admitted for relapse. Reasons for admission were non-compliance in 67.1% (77.2% due to lack of insight and 30.59% due to drug abuse), lack of therapeutic efficacy in 27.2%, and drug abuse in 24.3%. In addition, stress and a high incidence of side effects in 5.8% of patients were other reasons for relapse.

Non compliance is the main reason for relapses followed by lack of efficacy. The results appear to confirm that drug abuse might influence in a direct (drug abuse itself) or indirect (non compliance because of drug abuse) way in a higher number of relapses.