Determinants of Psychotic Relapse in Patients with Schizophrenia: A Cross-Sectional Study at the Federal Medical Center, Gusau, Zamfara State

Background: Schizophrenia remains a major public health concern globally due to its chronic, recurrent nature and the substantial burden it places on patients, caregivers, and health systems Schizophrenia is a chronic psychiatric disorder characterized by a relapsing-remitting course. This problem is even more pronounced in low-resource settings such as Nigeria, where socioeconomic instability, insecurity, inadequate access to mental health services, high treatment costs, cultural misconceptions, and caregiver burden significantly heighten relapse risk. In Northern Nigeria, high rates of readmission pose significant challenges to functional recovery and healthcare resources. This study investigated the factors contributing to relapse among patients with schizophrenia at Federal Medical Center (FMC) Gusau.Methods: A cross-sectional descriptive design was employed with a sample of 154 patients at the FMC Gusau, psychiatric unit. Data were collected using a structured questionnaire and medical record reviews. Logistic regression was used to identify independent predictors of relapse, with significance set at p < 0.05.Results: The majority of respondents were aged 26–35 years (35.7%) and male (63.6%). Significant patient-related factors included medication non-adherence (68.2%) and stopping medication upon symptom improvement (64.3%). Regression analysis identified the strongest predictors of relapse as missing medications (AOR = 3.85), high medication cost (AOR = 3.45), and lack of family supervision (AOR = 3.12).Conclusion: Relapse in this setting is primarily driven by economic barriers and failures in the community support system. Interventions should prioritize the affordability of antipsychotics and structured family psychoeducation to reduce the revolving door of psychiatric readmission.