Rehospitalization Risk in Community-Dwelling Schizophrenia Patients Receiving Paliperidone Palmitate: A Retrospective Cohort Study in Urban China

Rehospitalization Risk in Community-Dwelling Schizophrenia Patients Receiving Paliperidone Palmitate: A Retrospective Cohort Study in Urban China | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Rehospitalization Risk in Community-Dwelling Schizophrenia Patients Receiving Paliperidone Palmitate: A Retrospective Cohort Study in Urban China Cheng-Feng Liu, Jiao-Lian Yuan, Juan Cheng, Jing-Lu Lu, Wei-Yun Wang, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7943770/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 13 Dec, 2025 Read the published version in BMC Psychiatry → Version 1 posted 10 You are reading this latest preprint version Abstract Background While long-acting injectable paliperidone palmitate (PP-LAI) improves treatment adherence in schizophrenia, rehospitalization risks persist under community management. This study identified factors influencing rehospitalization in community-dwelling schizophrenia patients receiving PP-LAI. Methods A retrospective cohort study included 560 patients from 124 communities in Shenzhen (16 September 2022–15 September 2024). Data were extracted from medical databases. The primary outcome was rehospitalization due to psychiatric relapse. Cox regression models analyzed influencing factors. Results During a median follow-up of 14 months, 50 patients (8.93%) were rehospitalized (rate: 7.83 per 100 person-year). Treatment discontinuation (n = 133) was primarily due to adverse drug reactions (30.08%) and disease relapse (31.58%). Cox analysis identified guardian type (parents vs. spouse: HR = 2.16, 95% CI: 1.06–4.42), pre-study hospitalization history (yes vs. no: HR = 2.66, 95% CI: 1.49–4.75), and treatment discontinuity (discontinuation vs. regular treatment: HR = 8.64, 95% CI: 2.62–28.47) as independent risk factors for rehospitalization. Conclusions Treatment discontinuation is the strongest predictor of rehospitalization in PP-LAI-treated schizophrenia patients. Prior hospitalization and guardianship by parents also significantly increase risks. Clinical strategies should prioritize maintaining treatment continuity, proactively managing side effects, and strengthening family/community support for high-risk groups to reduce the risk of rehospitalization. Trial registration: Not applicable. (This is a retrospective observational study and does not involve a clinical trial requiring prospective registration). Schizophrenia Paliperidone Palmitate Long-Acting Injectable Antipsychotics Rehospitalization Treatment Adherence Retrospective Cohort Study Risk Factors Community Mental Health Figures Figure 1 Figure 2 1. Introduction Schizophrenia is a severe mental disorder associated with significant health, social, occupational, and economic burdens( 1 ). In China, the lifetime prevalence of schizophrenia and other psychotic disorders is as high as 0.75% ( 2 ), representing an estimated 10.5 million individuals. While antipsychotic treatment can control positive symptoms after the first episode, relapse is common during the course of the illness( 3 ). Each relapse is associated with reduced neuroplasticity, decreased gray matter volume, and significant declines in social function, interpersonal relationships, and quality of life, ultimately exacerbating the condition ( 4 ). Preventing relapse and reducing rehospitalization rates are central goals in the treatment of schizophrenia and major challenges for public mental health services ( 5 , 6 ). Antipsychotic medications are the first-line treatment for schizophrenia ( 1 , 7 , 8 ). However, for oral formulations, non-adherence rates can be as high as 50% ( 9 ). Studies have shown that non-adherence is the primary risk factor for relapse and rehospitalization( 10 ). To address this challenge, long-acting injectable antipsychotics were developed. Paliperidone palmitate is a second-generation LAI antipsychotic. Its active ingredient, paliperidone, is the major active metabolite of risperidone( 11 , 12 ). The formulation utilizes nanocrystal technology, which forms a depot upon intramuscular injection, enabling slow and sustained release, thereby maintaining stable plasma concentrations( 13 ). Compared to oral formulations, the once-monthly dosing regimen significantly improves treatment adherence, effectively reduces the risk of relapse ( 14 , 15 ), and may decrease side effects associated with fluctuations in plasma drug levels. It demonstrates high adherence, stable symptom control, and low relapse rates in the long-term maintenance treatment of schizophrenia, making it particularly suitable for the comprehensive management of community-dwelling patients with schizophrenia throughout the entire course of their illness( 16 , 17 ). International treatment guidelines recommend it as a key strategy for relapse prevention ( 14 , 15 ). Due to their unique pharmacokinetic properties and administration route, LAIs offer advantages over oral formulations in terms of adherence, stability of plasma drug concentrations, and long-term prognosis, making them particularly suitable for long-term maintenance therapy ( 16 , 17 ). They are recommended as a key strategy for relapse prevention in numerous international guidelines ( 14 , 15 , 18 ). Paliperidone palmitate long-acting injectable has demonstrated advantages in reducing hospitalization rates in both clinical trials and real-world studies( 14 , 15 ). However, translating this efficacy into real-world effectiveness remains a challenge. Patient outcomes are influenced not only by the medication alone but also by a combination of socio-demographic characteristics, disease severity, treatment regularity, and family support systems ( 10 , 19 , 20 ). Currently, there is insufficient research within China based on large community populations focusing on factors influencing rehospitalization after LAI treatment, particularly studies that distinguish between different adherence states and explore their impact. To address this gap, we conducted this study within a large, real-world community mental health system. This retrospective cohort study aimed to investigate the key factors associated with rehospitalization among community-dwelling schizophrenia patients treated with PP-LAI. It focused on analyzing the independent and interactive effects of treatment adherence, socio-demographic factors, and disease history on rehospitalization risk, to provide an evidence base for optimizing community-based intervention strategies in this region and nationwide. 2. Methods 2.1 Study Design The study was conducted in Bao'an District, Shenzhen, a major metropolitan area in China, recorded a gross domestic product (GDP) of 3.68 trillion RMB and had a permanent population of approximately 17.79 million in 2024. Community mental health services are provided through a tiered network managed by the District's Chronic Disease Control Hospital, which oversees patient registration, follow-up, and medication management. This retrospective cohort study enrolled community-managed patients diagnosed with schizophrenia from 124 com munities in Bao'an District, Shenzhen. Shenzhen, a representative example of rapid urbanization in China, Shenzhen has a demographic structure characterized by a high proportion of migrant populations and a young average age( 21 ), posing unique challenges for the long-term management of community-based patients with mental disorders. This study was approved by the Medical Ethics Committee of Bao'an District Chronic Disease Control Hospital (Approval No: 2024-01). All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from all individual participants and their guardians included in the study. 2.2 Participants Participants were identified from the Bao'an District Severe Mental Disorder Management System. All patients who initiated PP-LAI treatment between September 16, 2022, and September 15, 2024 were screened for eligibility. Inclusion criteria were: ( 1 ) diagnosis of schizophrenia according to ICD-10 codes F20-F29 ( 22 ); ( 2 ) age between 18 and 64 years before treatment initiation; ( 3 ) residence in Bao'an District with agreement to receive community services; ( 4 ) deemed suitable for LAI treatment by a psychiatrist and provision of signed informed consent for treatment; ( 5 ) completion of at least three LAI injections during the study period. Exclusion criteria were: ( 1 ) lack of baseline assessment data; ( 2 ) severe or unstable physical illness, history of acute or chronic renal failure; ( 3 ) liver cirrhosis or active liver disease; ( 4 ) any severe or unstable cardiovascular, neurological, respiratory, or other systemic diseases. A total of 560 patients meeting the criteria were included. The patient selection flowchart is presented in Fig. 1 . To assess whether the study had sufficient statistical power, a power analysis was performed based on the number of hospitalization events. The minimum number of events required was calculated using the Schoenfeld formula for a Cox proportional hazards model: D = (Z(1-α/2) + Z(1-β))² / (p * (1-p) * (ln(HR))². The calculation was parameterized with a hazard ratio (HR) of 2.50, derived from a previous study conducted in Shanghai( 23 ). A two-sided type I error (α) of 0.05 and a type II error (β) of 0.10, (90% power) were assumed, with an equal group allocation (p = 0.5). The analysis indicated that 51 events were required. Since the present study documented 50 hospitalization events, it achieved adequate statistical power to detect the hypothesized effect size. 2.3 Data Collection The baseline data was collected from the Shenzhen Mental Health Prevention and Management System, including age, household registration status, gender, education level, marital status, employment status, guardian-patient relationship, disease duration, reasons for treatment discontinuation, and history of high-risk behavior and hospitalization within three years prior to the study. Treatment details were extracted from the hospital's information system. Treatment adherence was categorized as: Regular : injections within the target window; Irregular : at least one injection outside the target window; Discontinuation : >6 months between PP1M injections or > 9 months for PP3M. Patients restarting after discontinuation were classified as Irregular . Trained community health doctors conducted follow-ups at least every three months. 2.4 Outcome The primary outcome of this study was the first rehospitalization due to psychiatric relapse after initiating PP-LAI treatment. Rehospitalization was defined as any hospital admission primarily for the exacerbation of schizophrenic symptoms, as recorded in the medical database systems. Secondary outcomes included the analysis of reasons for treatment discontinuation, which were categorized into adverse drug reactions, disease relapse, relocation, and other factors. 2.5 Study procedure This retrospective cohort study utilized data from the Bao’an District Severe Mental Disorder Management System and the Shenzhen Mental Health Prevention and Management System. Community-dwelling patients diagnosed with schizophrenia who received at least three injections of PP-LAI between September 16, 2022, and September 15, 2024, were included. Baseline demographic and clinical characteristics were collected from the Bao’an District Severe Mental Disorder Management System and the Shenzhen Mental Health Prevention and Management System. Patients were followed from the date of their first injection until the first occurrence of rehospitalization, the end of the study period (September 15, 2024), or the end of an additional observation period (June 15, 2025), whichever came first. An additional observation period (June 15, 2025) to account for potential lag in outcome occurrence, ensuring a minimum of 9 months of potential follow-up for all enrolled patients. Trained community health doctors conducted follow-up assessments at least once every three months. Treatment adherence was categorized as follows: Regular : injections administered within the predefined target window. Irregular : at least one injection administered outside the target window. Discontinuation : a gap of > 6 months between PP1M injections or > 9 months for PP3M. Patients who restarted treatment after discontinuation were subsequently categorized as Irregular . Data on rehospitalization events and treatment status were systematically extracted from the electronic medical records and follow-up reports. 2.6 Statistical Analysis Data were analyzed using SPSS 26.0. Continuous variables were described as mean (standard deviation) and compared using t-tests or ANOVA. Categorical variables were described as proportions (%) and compared using chi-square tests. Pairwise comparisons used the Bonferroni method. Cox proportional hazards regression models were used to identify factors associated with rehospitalization. Each patient's follow-up time was calculated from the date of their first PP-LAI injection until the date of their first rehospitalization, death, loss to follow-up, or the end of the study observation period, whichever occurred first. Patients who did not experience the outcome were censored at their last known date of contact or the study end date. The proportional hazards assumption was tested. A two-sided p-value < 0.05 was considered statistically significant. To assess the robustness of the primary findings, two sensitivity analyses were conducted. The first analysis aimed to address potential confounding by indication and to examine the heterogeneity of risk associated with different reasons for treatment discontinuation. The "discontinuation" group was subdivided into three categories based on the primary documented reason: ( 1 ) adverse drug reactions, ( 2 ) disease relapse or other disease-related reasons, and ( 3 ) other reasons (e.g., relocation, refusal). A multivariable Cox proportional hazards model was then performed, including these categories along the "regular" and "irregular" groups, and adjusted for significant covariates from the primary analysis (guardian relationship and pre-study hospitalization history). The second analysis evaluated the association between treatment adherence and rehospitalization in the subgroup of patients without any hospitalization history in the three years preceding the study. As the critical assumption of proportional hazards was untenable due to zero events in the regular treatment group, the differences in rehospitalization rates across the three adherence groups (regular, irregular, and discontinuation) were assessed using the Pearson's chi-square test. Furthermore, given the ordinal nature of the treatment adherence variable (representing a gradient of adherence from regular to discontinuation), a Cochran-Armitage test for trend was additionally employed to determine if a significant dose-response relationship existed. 3. Results 3.1 Baseline Characteristics The 560 patients, which accounted for 15.58% of schizophrenia patients under community management, had a mean age of 38.10 ± 10.15 years; and 51.43% were male. The cumulative follow-up was 638.54 person-years. Guardian relationship was spouse (30.71%) or parents (42.32%). 30.89% had a pre-study hospitalization history. Patients were categorized as regular (25.54%), irregular (50.71%), or discontinuation (23.75%) groups. Significant differences were found among adherence groups regarding pre-study hospitalization history, treatment phase, and adverse reactions (all p < 0.01; Table 1 ). Table 1 Baseline Characteristics of Hospitalization in Community-Dwelling Schizophrenia Patients Treated with Long-Acting Injectable Antipsychotics Characteristics Total (n = 560) Regular treatment group(n = 143) Irregular treatment group(n = 284) Discontinuation group(n = 133) F/χ 2 value P-value Age, years(Mean ± SD) 560(38.10 ± 10.15) 143(38.92 ± 10.19) 284(38.23 ± 10.26) 133(36.94 ± 9.84) 1.35 0.259 Household registration status, n (%)] 0.12 0.942 Local 98(17.50) 27(18.88) 53(18.66) 18(13.53) Non-local 462(82.50) 116(81.12) 231(81.34) 115(86.47) gender, n (%) 0.12 0.942 Male 288(51.43) 75(52.45) 146(51.41) 67(50.38) Female 272(48.57) 68(47.55) 138(48.59) 66(49.62) Education level, n (%) 0.41 0.982 Junior college and above 143(25.54) 23(23.96) 35(27.34) 85(25.30) Senior high school/technical secondary school 284(50.71) 49(51.04) 64(50.00) 171(50.89) Junior high school and below 133(23.75) 24(25.00) 29(22.66) 80(23.81) Marital status, n (%) 3.58 0.466 Married 236(42.14) 63(44.06) 122(42.96) 51(38.35) Unmarried 286(51.07) 68(47.55) 142(50.00) 76(57.14) Divorced or widowed 38(6.79) 12(8.39) 20(7.04) 6(4.51) Employment status, n (%) 1.96 0.743 Employed 212(37.86) 58(40.56) 105(36.97) 49(36.84) Unemployed 272(48.57) 63(44.06) 144(50.70) 65(48.87) Student or other 76(13.57) 22(15.38) 35(12.32) 19(14.29) Relationship of guardian to patient, n (%) 12.22 0.142 Spouse 172(30.71) 45(31.47) 87(30.63) 40(30.08) Parent 237(42.32) 58(40.56) 120(42.25) 59(44.36) Child 27(4.82) 6(4.20) 17(5.99) 4(3.01) Sibling 99(17.68) 29(20.28) 52(18.31) 18(13.53) Other 25(4.46) 5(3.50) 8(2.82) 12(9.02) Duration of illness, years, n (%) 6.57 0.160 0~ 102(18.21) 26(18.18) 43(15.14) 33(24.81) 6~ 151(26.96) 35(24.48) 80(28.17) 36(27.07) 10 ~ 42 307(54.82) 82(57.34) 161(56.69) 64(48.12) High-risk status prior to study, n (%) 0.24 0.887 No 528(94.29) 136(95.10) 267(94.01) 125(93.98) Yes 32(5.71) 7(4.90) 17(5.99) 8(6.02) Pre-study hospitalization history, n (%) 19.73 < 0.001 No 387(69.11) 106(74.13) 173(60.92) 108(81.20) Yes 173(30.89) 37(25.87) 111(39.08) 25(18.80) Treatment phase at last injection, n (%) 80.30 < 0.001 PP1M 478(85.36) 143(100.00) 205(72.18) 130(97.74) PP3M 82(14.64) 0(0.00) 79(27.82) 3(2.26) Concomitant antipsychotic use, n (%) 5.09 0.658 No 284(50.71) 68(47.55) 157(55.28) 59(44.36) Yes 276(49.29) 75(52.45) 127(44.72) 74(55.64) Adverse drug reactions, n (%) 79.26 < 0.001 No 503(89.82) 143(100.00) 267(94.01) 93(69.92) Yes 57(10.18) 0(0.00) 17(5.99) 40(30.08) Rehospitalization (Outcome), n (%) 37.67 < 0.001 No 510(91.07) 140(97.90) 266(93.66) 104(78.20) Yes 50(8.93) 3(2.10) 18(6.34) 29(21.80) Note: We compared patient age across the different treatment adherence groups using analysis of variance (ANOVA) 3.2 Reasons for Treatment Discontinuation A total of 133 patients discontinued treatment. Adverse drug reactions accounted for 40 cases (30.08%), primarily hyperprolactinemia (n = 17) and extrapyramidal symptoms (n = 10). Other prevalent reasons included disease relapse (n = 42, 31.58%), and relocation (n = 32, 24.06%). Among other miscellaneous reasons, the emergence of symptoms (n = 23) and hospitalization (n = 18) were most frequently noted.(Table 2 ). Table 2 Categorization of reasons for treatment discontinuation among patients receiving long-acting injectable antipsychotics(n = 133). Reason for Discontinuation n(%) Specific causes Adverse Drug Reactions 40(30.08) Hyperprolactinemia: 17 Extrapyramidal symptoms: 10 Sleep disturbances: 5 Dizziness or headache: 8 Disease Relapse 42(31.58) Emergence of symptoms: 23 Hospitalization: 18 Aggressive behavior: 1 Medical Record Transfer 32(24.06) Medical Record Transfer: 32 Other Reasons 19(14.29) Pain: 10 Need for concomitant medications: 4 Inaccessibility of healthcare facility: 1 Refusal by family members: 1 Refusal of both oral and LAIs: 2 Physical illness: 1 3.3 Univariate and Multivariate Analysis of Rehospitalization During the follow-up period, 50 patients (8.93%) were rehospitalized, corresponding to an overall incidence rate of 7.83 per 100 person-years. The Log-rank test showed a statistically significant difference in rehospitalization rates among groups with different treatment adherence patterns(χ 2 =33.60, p < 0.001; ,Fig. 2 ). Univariate analysis showed significant associations between rehospitalization and employment status, guardian relationship, pre-study hospitalization history, adverse reactions, and treatment regularity (all p < 0.05). Multivariate Cox analysis identified guardian relationship (parents vs. spouse: HR = 2.16, 95%CI: 1.06–4.42), pre-study hospitalization history (yes vs. no: HR = 2.66, 95%CI: 1.49–4.75), and treatment regularity (Discontinuation vs. Regular: HR = 8.64, 95%CI: 2.62–28.47) as independent predictors. No significant interaction was found between pre-study hospitalization history and treatment regularity (χ²=0.55, p = 0.759; Table 3 and Table 4 ). Table 3 Univariate Analysis of Hospitalization in Community-Dwelling Patients with Schizophrenia Receiving Long-Acting Injectable Antipsychotics Characteristics Total (n = 560) Rehospitalization group(n = 50) Non-hospitalized group(n = 510) χ 2 /t P Age, years(Mean ± SD) 38.10 ± 10.15 33.68 ± 10.55 38.53 ± 10.02 3.25 a 0.001 Household registration, n (%)] 0.77 0.380 Local 98(17.50) 11(11.22) 87(88.78) Non-local 462(82.50) 39(8.44) 423(91.56) gender, n (%) 0.95 0.330 Male 288(51.43) 29(10.07) 259(89.93) Female 272(48.57) 21(7.72) 251(92.28) Education level, n (%) 0.94 0.626 Junior college and above 96(17.14) 8(8.33) 88(91.67) Senior high school/technical secondary school 128(22.86) 9(7.03) 119(92.97) Junior high school and below 336(60.00) 33(9.82) 303(90.18) Marital status, n (%) 4.64 0.098 Married 236(42.14) 15(6.36) 221(93.64) Unmarried 286(51.07) 29(10.14) 257(89.86) Divorced or widowed 38(6.79) 6(15.79) 32(84.21) Employment status, n (%) 8.31 0.016 Employed 212(37.86) 12(5.66) 200(94.34) Unemployed 272(48.57) 34(12.50) 238(87.50) Student or other 76(13.57) 4(5.26) 72(94.74) Relationship of guardian to patient, n (%) 13.06 0.011 Spouse 172(30.71) 10(5.81) 162(94.19) Parent 237(5.89) 33(13.92) 204(86.08) Child 27(4.82) 2(7.41) 25(92.59) Sibling 99(17.68) 4(4.04) 95(95.96) Other 25(4.46) 1(4.00) 24(96.00) Duration of illness, years, n (%) 1.70 0.428 0~ 102(18.21) 6(5.88) 96(94.12) 6~ 151(26.96) 13(8.61) 138(91.39) 10 ~ 42 307(54.82) 31(10.10) 276(89.90) High-risk status prior to study, n (%) 1.10 0.294 No 528(94.29) 45(8.52) 483(91.48) Yes 32(5.71) 5(15.63) 27(84.38) Pre-study hospitalization history, n (%) 9.39 0.002 No 387(69.11) 25(6.46) 362(93.54) Yes 173(30.89) 25(14.45) 148(85.55) Treatment phase at last injection, n (%) 4.98 0.026 PP1M 478(85.36) 48(10.04) 430(89.96) PP3M 82(14.64) 2(2.44) 80(97.56) Concomitant antipsychotic use, n (%) 0.99 0.320 No 284(50.71) 22(7.75) 262(92.25) Yes 276(49.29) 28(10.14) 248(89.86) Adverse drug reactions, n (%) 15.03 < 0.001 No 503(89.82) 37(7.36) 466(92.64) Yes 57(10.18) 13(22.81) 44(77.19) PP-LAI treatment adherence,n (%) 37.67 < 0.001 Regular treatment 143(25.54) 3(2.10) 140(97.90) Irregular treatment group 284(50.71) 18(6.34) 266(93.66) Discontinuation 133(23.75) 29(21.80) 104(78.20) Note: a Comparison of age between hospitalized and non-hospitalized groups used t-test Table 4 Cox Survival Analysis of Hospitalization in Community-Dwelling Schizophrenia Patients Receiving Long-Acting Injectable Antipsychotics Characteristics β SE Waldχ 2 value P-value Hazard Ratio (HR)(95%CI) Relationship of guardian to patient 8.80 0.043 Spouse 1.00 Parent 0.77 0.36 4.50 0.034 2.16(1.06–4.42) Child 0.35 0.78 0.21 0.651 1.42(0.31–6.52) Sibling -0.38 0.59 0.40 0.525 0.69(0.21–2.19) Other -0.44 1.05 0.17 0.678 0.65(0.08–5.10) Pre-study hospitalization history 10.92 < 0.001 no 1.00 yes 0.98 0.30 10.92 < 0.001 2.66(1.49–4.75) PP-LAI treatment adherence 32.71 < 0.001 Regular treatment 1 Irregular treatment group 0.56 0.63 0.81 0.369 1.76(0.51-6.00) Discontinuation 2.16 0.61 12.57 < 0.001 8.64(2.62–28.47) Treatment phase at last injection 2.40 0.121 PP1M 1 PP3M -1.16 0.75 2.40 0.121 0.31(0.07–1.36) Marital status 3.69 0.158 Married 1.00 Unmarried -0.34 0.53 0.43 0.514 0.71(0.25–1.99) Divorced or widowed 0.59 0.62 0.89 0.347 1.80(0.53–6.09) Age, years 1.55 0.213 18 ~ 44 1.00 45–64 -0.71 0.57 1.55 0.213 0.41(0.14 ~ 1.20) Employment status 4.59 0.101 Employed 1.00 Unemployed 0.67 0.35 3.82 0.051 1.96(1.00-3.86) Student or other 0.04 0.59 0.00 0.950 1.04(0.32–3.33) Adverse drug reactions, n (%) 1.53 0.217 1.00 No Yes 0.45 0.37 1.53 0.217 1.57(0.77–3.21) 3.4 Sensitivity analyses ​ ​3.4.1 Discontinuation for Specific Reasons​​ In the multivariate Cox model adjusting for guardian relationship and pre-study hospitalization history, discontinuation due to disease relapse/related reasons (vs. regular treatment: HR = 19.82, 95% CI: 5.91–66.47) and a history of hospitalization within the 3 years prior to the study (yes vs. no: HR = 3.21, 95% CI: 1.59–6.45) remained independent predictors of rehospitalization. Discontinuation due to ADRs (ADRs vs. Regular: HR = 3.23, 95% CI: 0.72 − 14.49) and other reasons (other reasons vs. Regular: HR = 3.56, 95% CI: 0.79 − 15.98) showed a non-significant trend (Table 5 ). Table 5 Factors Associated with Rehospitalization Among Patients Discontinuing PP-LAI for Different Reasons Characteristics β SE Waldχ 2 value P-value Hazard Ratio (HR)(95%CI) Pre-study hospitalization history 10.66 0.001 no 1.00 yes 1.17 0.36 10.66 0.001 3.21(1.59–6.45) Reason for Discontinuation 34.99 < 0.001 Regular treatment 1.00 Adverse Drug Reactions 1.17 0.77 2.35 0.125 3.23(0.72–14.49) Disease Relapse 2.99 0.62 23.39 < 0.001 19.82(5.91–66.47) Other Reasons 1.27 0.77 2.74 0.098 3.56(0.79–15.98) ​3.4.2 Subgroup without Pre-Study Hospitalization​​ Analysis of the subcohort without pre-study hospitalization history (n = 387) revealed a highly significant association between treatment adherence and rehospitalization (χ² = 23.68, P < 0.001). No events occurred in the regular treatment group (n = 106), whereas 8 and 17 events occurred in the irregular (n = 173) and discontinuation (n = 108) groups, respectively. A significant dose-response trend of increasing rehospitalization rates was observed across the adherence gradient (Cochran-Armitage test for trend, χ²trend = 21.95, P < 0.001; Table 6 ). Table 6 Rehospitalization in PP-LAI Patients Without Pre-study hospitalization history, Stratified by Treatment Adherence Characteristics Rehospitalization Non-hospitalized χ 2 p PP-LAI treatment adherence, n (%) Regular treatment 0(0.00) 106(100.00) 23.68 < 0.001 Irregular treatment group 8(4.60) 165(94.40) Discontinuation 17(15.70) 91(84.30) Note: The Cochran-Armitage test revealed a significant increasing trend in the proportion of rehospitalizations across the regular, irregular, and discontinuation groups（χ²trend = 21.95, P < 0.001 4. Discussion This retrospective cohort study of 560 community-dwelling patients with schizophrenia receiving PP-LAI in Bao'an District, Shenzhen, identified treatment adherence, prior hospitalization history, and the patient-guardian relationship as independent predictors of hospitalization. The most salient finding was the decisive impact of treatment regularity, with the treatment discontinuation group exhibiting an 8.64-fold increased risk compared to the regular treatment group, demonstrating a clear risk gradient. This finding robustly validates the fundamental rationale for LAI antipsychotics—to enhance illness stability and prevent relapse by overcoming adherence challenges inherent to oral regimens, which is consistent with a substantial body of prior research ( 14 , 17 , 18 , 23 ). However, the high combined rate of irregular treatment and discontinuation (74.46%) in our cohort underscores the persistent challenges within community mental health services, particularly concerning consistent patient follow-up, proactive management of adverse effects, and sustained patient supervision. The primary reasons for discontinuation of PP-LAI, a dopamine D2 receptor antagonist, were adverse drug reactions (ADRs) and disease recurrence (30.08% and 31.58%). Understanding its pharmacologic profile is crucial for developing effective interventions. Its efficacy is mediated primarily through central D2 receptor antagonism ( 24 , 25 ), but this action is non-specific and can lead to various side effects. Blockade of D2 receptors in the tuberoinfundibular pathway can induce hyperprolactinemia ( 26 , 27 ), while antagonism in the nigrostriatal pathway may cause extrapyramidal symptoms ( 28 , 29 ). Additionally, antagonism at histamine H1 receptors is associated with sedation and weight gain ( 30 ), and alpha-1 adrenergic receptor blockade can lead to orthostatic hypotension ( 16 , 31 ). Recurrence during PP-LAI treatment may be related to subtherapeutic drug concentrations, particularly during initiation or towards the end of the dosing interval, leading to insufficient blockade of the mesolimbic dopamine pathway and potential dopamine rebound ( 25 ). Furthermore, intolerable ADRs, such as akathisia, can themselves act as stressors, potentially precipitating agitation and indirectly contributing to relapse ( 32 ). Guided by this mechanistic understanding, a multi-faceted intervention strategy is essential to maximize the benefits of PP-LAI while effectively managing risks. At the clinical level, an individualized treatment approach is paramount, involving comprehensive pre-treatment assessment, adherence to the principle of using the lowest effective dose, regular monitoring of weight, metabolic parameters, and movement disorders, and prompt management of ADRs (e.g., using trihexyphenidyl or aripiprazole to mitigate extrapyramidal symptoms) ( 33 ). When switching from oral antipsychotics, ensuring an adequate overlap period and employing correct loading strategies are critical to rapidly achieve steady-state plasma levels. At the public health and community level, strengthening regular follow-up, symptom monitoring, and family education is vital. Establishing clear early warning indicators (e.g., refusal of injection, worsening insomnia) and emergency protocols, alongside promoting the concept of using LAIs early in the illness course for integrated management, can systematically enhance adherence and reduce relapse risk. Our study also confirms that a history of hospitalization prior to the study period is another independent risk factor, with affected patients having a 2.66-fold higher risk. This easily obtainable metric effectively identifies greater illness severity, chronicity, and potential treatment resistance ( 34 ), a finding consistent with extensive previous literature. As Emsley R et al. suggested, relapse is not merely a return of symptoms but is associated with adverse neuroplastic changes and reduced grey matter volume, leading to significant declines in social function and quality of life, thereby creating a vicious cycle of deterioration ( 4 ). This underscores the critical need for intensified monitoring and comprehensive support for this high-risk subgroup, even after initiating LAI treatment. A noteworthy and somewhat counterintuitive finding was the significantly higher risk of hospitalization (HR = 2.16) for patients under the guardianship of their parents compared to those under the guardianship of their spouses. This finding may reflect profound family dynamics and sociological factors. It could indicate underlying demographic differences between these groups; patients with parental guardians might be younger, have shorter illness durations, and their families may lack caregiving experience. Alternatively, aging parents may have diminished capacity for care due to generational gaps or their own health issues. More importantly, compared to the more egalitarian partnership often found in spousal relationships, parent-child guardian dynamics may be associated with higher levels of "expressed emotion"—encompassing criticism, hostility, or emotional over-involvement—which is a well-established psychosocial risk factor for relapse in schizophrenia ( 10 , 35 – 37 ). The long-term care burden and economic pressure on parents may also impact the quality of support ( 38 ). A limitation of this study is the lack of detailed assessment of guardians' age, health status, family functioning, and emotional climate, which leaves room for residual confounding. Thus, the "parental guardianship" variable may be a proxy for other unmeasured risk factors, such as greater patient severity or lower socioeconomic status, necessitating further investigation. Compared to previous studies, our conclusions not only reinforce the central role of treatment adherence and prior history but also hold particular significance due to our cohort's characteristics. The high proportions of non-local residents (82.50%) and unemployed/laid-off individuals (48.57%) accurately reflect the typical scenario and unique challenges of managing mental disorders in communities undergoing rapid urbanization in China. The high rate of treatment irregularity suggests that targeted social support policies and interventions for these mobile and socioeconomically vulnerable populations are key to improving the effectiveness of regional mental health services. Several limitations must be acknowledged. First, the unknown confounding factors may exist. Second, the measurement of key variables, such as the "guardian relationship," was relatively crude, lacking depth. Finally, the sample was drawn from a single district, which may limit the generalizability of the findings and requires cautious external validation. 5. Conclusion In summary, this study demonstrates that treatment adherence is the critical factor for preventing hospitalization in community-dwelling patients with schizophrenia treated with LAIs, while a history of prior hospitalization and parental guardianship serve as important markers for identifying high-risk individuals. Our findings imply that successful community-based management cannot rely solely on advanced pharmacotherapy. It necessitates an integrated model that combines standardized medication, proactive community follow-up services, and scientifically-supported family systems. Future research should employ prospective designs to elucidate the mechanisms underlying the influence of guardian relationships and to develop targeted family intervention strategies, thereby more effectively reducing hospitalization rates and improving patients' quality of life. Abbreviations ADRs Adverse Drug Reactions CI Confidence Interval HR Hazard Ratio LAI Long-Acting Injectable PP-LAI Paliperidone Palmitate Long-Acting Injectable PP1M Once-Monthly Paliperidone Palmitate PP3M Three-Monthly Paliperidone Palmitate Declarations Ethics approval and consent to participate: This study was approved by the Medical Ethics Committee of Bao'an District Chronic Disease Control Hospital (Approval No: 2024-01). Informed consent was obtained from all participants and their guardians. Consent for publication: Not applicable. (This manuscript contains no individual person’s data). Competing interests The authors declare that they have no competing interests. Funding: This work was supported by: • The Shenzhen Science and Technology Program (Grant No. JCYJ20220531091006014). • The 2024 Bao’an District Medical and Health Research Project (Grant No. 2024JD230). • The Bao’an District Key Medical Discipline (Prevention and Control of Chronic Non-Communicable Diseases). Author Contribution CF L and JL Y contributed equally to this work. CF L, JL Y, and YF G conceived and designed the study. CF L, J C, JL L, WY W, CH L and L Q collected and analyzed the data. CF L and JL Y drafted the manuscript. SL Z, X Y, L Z and YF G critically revised the manuscript. All authors read and approved the final manuscript. Acknowledgements: The authors thank the community health workers for their assistance in data collection. Availability of data and materials: The datasets generated and/or analysed during the current study are not publicly available due to containing information that could compromise the privacy of patients with severe mental disorders but are available from the corresponding author on reasonable request. References Keepers GA, Fochtmann LJ, Anzia JM, Benjamin S, Lyness JM, Mojtabai R, et al. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia. Am J Psychiatry. 2020;177(9):868–72. Huang Y, Wang Y, Wang H, Liu Z, Yu X, Yan J, et al. Prevalence of mental disorders in China: a cross-sectional epidemiological study. Lancet Psychiatry. 2019;6(3):211–24. Alvarez-Jimenez M, Priede A, Hetrick SE, Bendall S, Killackey E, Parker AG, et al. 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Population Pharmacokinetic Modeling of TV-46000, a Risperidone Long-Acting Subcutaneous Antipsychotic for the Treatment of Patients with Schizophrenia. Neurol therapy. 2025;14(3):829–48. Chouinard G, Samaha AN, Chouinard VA, Peretti CS, Kanahara N, Takase M, et al. Antipsychotic-Induced Dopamine Supersensitivity Psychosis: Pharmacology, Criteria, and Therapy. Psychother Psychosom. 2017;86(4):189–219. Lin X, Siafis S, Tian J, Wu H, Qin M, Correll CU, et al. Antipsychotic-Related Prolactin Changes: A Systematic Review and Dose-Response Meta-analysis. CNS Drugs. 2025;39(10):937–47. Abe Y, Yagishita S, Sano H, Sugiura Y, Dantsuji M, Suzuki T, et al. Shared GABA transmission pathology in dopamine agonist- and antagonist-induced dyskinesia. Cell Rep Med. 2023;4(10):101208. Yoshida K, Bies RR, Suzuki T, Remington G, Pollock BG, Mizuno Y, et al. Tardive dyskinesia in relation to estimated dopamine D2 receptor occupancy in patients with schizophrenia: analysis of the CATIE data. Schizophr Res. 2014;153(1–3):184–8. Leucht S, Schneider-Thoma J, Burschinski A, Peter N, Wang D, Dong S, et al. Long-term efficacy of antipsychotic drugs in initially acutely ill adults with schizophrenia: systematic review and network meta-analysis. World psychiatry: official J World Psychiatric Association (WPA). 2023;22(2):315–24. Nkemjika S, Singh S, Wayne K, Oforeh K, Saha A. Risperidone induced hypotension: A case report and literature review. J Natl Med Assoc. 2022;114(6):621–3. Kane JM. Lessening the Side Effect Burden to Improve Adherence Among Individuals With Schizophrenia. J Clin Psychiatry. 2021;82(2). Grygiel-Górniak B, Puszczewicz M. A review on irisin, a new protagonist that mediates muscle-adipose-bone-neuron connectivity. Eur Rev Med Pharmacol Sci. 2017;21(20):4687–93. Naguy A, Al-Khadhari S. Anismus-A Very Unusual Extrapyramidal Side Effect of Paliperidone Palmitate in an Adolescent with Schizo-Affective Disorder. Psychopharmacol Bull. 2024;54(3):100–2. Deng M, Zhai S, Ouyang X, Liu Z, Ross B. Factors influencing medication adherence among patients with severe mental disorders from the perspective of mental health professionals. BMC Psychiatry. 2022;22(1):22. Borojevic N, Dawud M, Xiao J, Yun Y. Long-acting injectable paliperidone palmitate induced severe cutaneous allergic reaction in a patient with first episode delusional disorder tolerating oral paliperidone regimen: a case report. BMC Psychiatry. 2022;22(1):734. Schoretsanitis G, Haen E, Piacentino D, Conca A, Endres K, Carpi F, et al. Pharmacokinetic Correlates of Once-Monthly Paliperidone Palmitate-Related Adverse Drug Reactions. Clin Pharmacokinet. 2021;60(12):1583–9. Gou L, Su R, Guo R, Li L, Li J, Zhou B, et al. Efficacy and safety of paliperidone palmitate 1-month formulation (PP1M) for schizophrenia in southwestern China. BMC Psychiatry. 2025;25(1):342. Additional Declarations No competing interests reported. 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1","display":"","copyAsset":false,"role":"figure","size":29395,"visible":true,"origin":"","legend":"\u003cp\u003eFlowchart detailing the selection process for eligible participants.\u003c/p\u003e","description":"","filename":"groupimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7943770/v1/1cf849f4c34d33f1e1112f5d.jpeg"},{"id":95665207,"identity":"255964c1-a057-42f5-879e-f663b6157ddb","added_by":"auto","created_at":"2025-11-11 16:44:22","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":20445,"visible":true,"origin":"","legend":"\u003cp\u003eThe rehospitalization rates among groups with different treatment adherence patterns\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7943770/v1/235c73b6e606c7a8dd0c917a.png"},{"id":98244382,"identity":"22605af8-8180-443c-a909-bf2b463b59de","added_by":"auto","created_at":"2025-12-15 16:14:12","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1705836,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7943770/v1/b0133061-dc24-4710-a043-2ed9aad1543c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Rehospitalization Risk in Community-Dwelling Schizophrenia Patients Receiving Paliperidone Palmitate: A Retrospective Cohort Study in Urban China","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eSchizophrenia is a severe mental disorder associated with significant health, social, occupational, and economic burdens(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). In China, the lifetime prevalence of schizophrenia and other psychotic disorders is as high as 0.75% (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e), representing an estimated 10.5\u0026nbsp;million individuals. While antipsychotic treatment can control positive symptoms after the first episode, relapse is common during the course of the illness(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Each relapse is associated with reduced neuroplasticity, decreased gray matter volume, and significant declines in social function, interpersonal relationships, and quality of life, ultimately exacerbating the condition (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Preventing relapse and reducing rehospitalization rates are central goals in the treatment of schizophrenia and major challenges for public mental health services (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAntipsychotic medications are the first-line treatment for schizophrenia (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). However, for oral formulations, non-adherence rates can be as high as 50% (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Studies have shown that non-adherence is the primary risk factor for relapse and rehospitalization(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). To address this challenge, long-acting injectable antipsychotics were developed. Paliperidone palmitate is a second-generation LAI antipsychotic. Its active ingredient, paliperidone, is the major active metabolite of risperidone(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). The formulation utilizes nanocrystal technology, which forms a depot upon intramuscular injection, enabling slow and sustained release, thereby maintaining stable plasma concentrations(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Compared to oral formulations, the once-monthly dosing regimen significantly improves treatment adherence, effectively reduces the risk of relapse (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e), and may decrease side effects associated with fluctuations in plasma drug levels. It demonstrates high adherence, stable symptom control, and low relapse rates in the long-term maintenance treatment of schizophrenia, making it particularly suitable for the comprehensive management of community-dwelling patients with schizophrenia throughout the entire course of their illness(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). International treatment guidelines recommend it as a key strategy for relapse prevention (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eDue to their unique pharmacokinetic properties and administration route, LAIs offer advantages over oral formulations in terms of adherence, stability of plasma drug concentrations, and long-term prognosis, making them particularly suitable for long-term maintenance therapy (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). They are recommended as a key strategy for relapse prevention in numerous international guidelines (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e).\u003c/p\u003e\u003cp\u003ePaliperidone palmitate long-acting injectable has demonstrated advantages in reducing hospitalization rates in both clinical trials and real-world studies(\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). However, translating this efficacy into real-world effectiveness remains a challenge. Patient outcomes are influenced not only by the medication alone but also by a combination of socio-demographic characteristics, disease severity, treatment regularity, and family support systems (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Currently, there is insufficient research within China based on large community populations focusing on factors influencing rehospitalization after LAI treatment, particularly studies that distinguish between different adherence states and explore their impact.\u003c/p\u003e\u003cp\u003eTo address this gap, we conducted this study within a large, real-world community mental health system. This retrospective cohort study aimed to investigate the key factors associated with rehospitalization among community-dwelling schizophrenia patients treated with PP-LAI. It focused on analyzing the independent and interactive effects of treatment adherence, socio-demographic factors, and disease history on rehospitalization risk, to provide an evidence base for optimizing community-based intervention strategies in this region and nationwide.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1 Study Design\u003c/h2\u003e\u003cp\u003eThe study was conducted in Bao'an District, Shenzhen, a major metropolitan area in China, recorded a gross domestic product (GDP) of 3.68 trillion RMB and had a permanent population of approximately 17.79\u0026nbsp;million in 2024. Community mental health services are provided through a tiered network managed by the District's Chronic Disease Control Hospital, which oversees patient registration, follow-up, and medication management.\u003c/p\u003e\u003cp\u003eThis retrospective cohort study enrolled community-managed patients diagnosed with schizophrenia from 124 com munities in Bao'an District, Shenzhen. Shenzhen, a representative example of rapid urbanization in China, Shenzhen has a demographic structure characterized by a high proportion of migrant populations and a young average age(\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e), posing unique challenges for the long-term management of community-based patients with mental disorders. This study was approved by the Medical Ethics Committee of Bao'an District Chronic Disease Control Hospital (Approval No: 2024-01). All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from all individual participants and their guardians included in the study.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2 Participants\u003c/h2\u003e\u003cp\u003eParticipants were identified from the Bao'an District Severe Mental Disorder Management System. All patients who initiated PP-LAI treatment between September 16, 2022, and September 15, 2024 were screened for eligibility. Inclusion criteria were: (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) diagnosis of schizophrenia according to ICD-10 codes F20-F29 (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e); (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) age between 18 and 64 years before treatment initiation; (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) residence in Bao'an District with agreement to receive community services; (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) deemed suitable for LAI treatment by a psychiatrist and provision of signed informed consent for treatment; (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) completion of at least three LAI injections during the study period. Exclusion criteria were: (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) lack of baseline assessment data; (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) severe or unstable physical illness, history of acute or chronic renal failure; (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) liver cirrhosis or active liver disease; (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) any severe or unstable cardiovascular, neurological, respiratory, or other systemic diseases. A total of 560 patients meeting the criteria were included. The patient selection flowchart is presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eTo assess whether the study had sufficient statistical power, a power analysis was performed based on the number of hospitalization events. The minimum number of events required was calculated using the Schoenfeld formula for a Cox proportional hazards model: D = (Z(1-α/2)\u0026thinsp;+\u0026thinsp;Z(1-β))\u0026sup2; / (p * (1-p) * (ln(HR))\u0026sup2;. The calculation was parameterized with a hazard ratio (HR) of 2.50, derived from a previous study conducted in Shanghai(\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). A two-sided type I error (α) of 0.05 and a type II error (β) of 0.10, (90% power) were assumed, with an equal group allocation (p\u0026thinsp;=\u0026thinsp;0.5). The analysis indicated that 51 events were required. Since the present study documented 50 hospitalization events, it achieved adequate statistical power to detect the hypothesized effect size.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3 Data Collection\u003c/h2\u003e\u003cp\u003eThe baseline data was collected from the Shenzhen Mental Health Prevention and Management System, including age, household registration status, gender, education level, marital status, employment status, guardian-patient relationship, disease duration, reasons for treatment discontinuation, and history of high-risk behavior and hospitalization within three years prior to the study. Treatment details were extracted from the hospital's information system. \u003cem\u003eTreatment adherence\u003c/em\u003e was categorized as: \u003cem\u003eRegular\u003c/em\u003e: injections within the target window; \u003cem\u003eIrregular\u003c/em\u003e: at least one injection outside the target window; \u003cem\u003eDiscontinuation\u003c/em\u003e: \u0026gt;6 months between PP1M injections or \u0026gt;\u0026thinsp;9 months for PP3M. Patients restarting after discontinuation were classified as \u003cem\u003eIrregular\u003c/em\u003e. Trained community health doctors conducted follow-ups at least every three months.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003e2.4 Outcome\u003c/h2\u003e\u003cp\u003eThe primary outcome of this study was the first rehospitalization due to psychiatric relapse after initiating PP-LAI treatment. Rehospitalization was defined as any hospital admission primarily for the exacerbation of schizophrenic symptoms, as recorded in the medical database systems.\u003c/p\u003e\u003cp\u003eSecondary outcomes included the analysis of reasons for treatment discontinuation, which were categorized into adverse drug reactions, disease relapse, relocation, and other factors.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003e2.5 Study procedure\u003c/h2\u003e\u003cp\u003eThis retrospective cohort study utilized data from the Bao\u0026rsquo;an District Severe Mental Disorder Management System and the Shenzhen Mental Health Prevention and Management System. Community-dwelling patients diagnosed with schizophrenia who received at least three injections of PP-LAI between September 16, 2022, and September 15, 2024, were included.\u003c/p\u003e\u003cp\u003eBaseline demographic and clinical characteristics were collected from the Bao\u0026rsquo;an District Severe Mental Disorder Management System and the Shenzhen Mental Health Prevention and Management System. Patients were followed from the date of their first injection until the first occurrence of rehospitalization, the end of the study period (September 15, 2024), or the end of an additional observation period (June 15, 2025), whichever came first. An additional observation period (June 15, 2025) to account for potential lag in outcome occurrence, ensuring a minimum of 9 months of potential follow-up for all enrolled patients.\u003c/p\u003e\u003cp\u003eTrained community health doctors conducted follow-up assessments at least once every three months. Treatment adherence was categorized as follows:\u003c/p\u003e\u003cp\u003e\u003cb\u003eRegular\u003c/b\u003e: injections administered within the predefined target window.\u003c/p\u003e\u003cp\u003e\u003cb\u003eIrregular\u003c/b\u003e: at least one injection administered outside the target window.\u003c/p\u003e\u003cp\u003e\u003cb\u003eDiscontinuation\u003c/b\u003e: a gap of \u0026gt;\u0026thinsp;6 months between PP1M injections or \u0026gt;\u0026thinsp;9 months for PP3M. Patients who restarted treatment after discontinuation were subsequently categorized as \u003cem\u003eIrregular\u003c/em\u003e.\u003c/p\u003e\u003cp\u003eData on rehospitalization events and treatment status were systematically extracted from the electronic medical records and follow-up reports.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003e2.6 Statistical Analysis\u003c/h2\u003e\u003cp\u003eData were analyzed using SPSS 26.0. Continuous variables were described as mean (standard deviation) and compared using t-tests or ANOVA. Categorical variables were described as proportions (%) and compared using chi-square tests. Pairwise comparisons used the Bonferroni method. Cox proportional hazards regression models were used to identify factors associated with rehospitalization. Each patient's follow-up time was calculated from the date of their first PP-LAI injection until the date of their first rehospitalization, death, loss to follow-up, or the end of the study observation period, whichever occurred first. Patients who did not experience the outcome were censored at their last known date of contact or the study end date. The proportional hazards assumption was tested. A two-sided p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e\u003cp\u003eTo assess the robustness of the primary findings, two sensitivity analyses were conducted. The first analysis aimed to address potential confounding by indication and to examine the heterogeneity of risk associated with different reasons for treatment discontinuation. The \"discontinuation\" group was subdivided into three categories based on the primary documented reason: (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) adverse drug reactions, (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) disease relapse or other disease-related reasons, and (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) other reasons (e.g., relocation, refusal). A multivariable Cox proportional hazards model was then performed, including these categories along the \"regular\" and \"irregular\" groups, and adjusted for significant covariates from the primary analysis (guardian relationship and pre-study hospitalization history). The second analysis evaluated the association between treatment adherence and rehospitalization in the subgroup of patients without any hospitalization history in the three years preceding the study. As the critical assumption of proportional hazards was untenable due to zero events in the regular treatment group, the differences in rehospitalization rates across the three adherence groups (regular, irregular, and discontinuation) were assessed using the Pearson's chi-square test. Furthermore, given the ordinal nature of the treatment adherence variable (representing a gradient of adherence from regular to discontinuation), a Cochran-Armitage test for trend was additionally employed to determine if a significant dose-response relationship existed.\u003c/p\u003e\u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003e3.1 Baseline Characteristics\u003c/h2\u003e\u003cp\u003eThe 560 patients, which accounted for 15.58% of schizophrenia patients under community management, had a mean age of 38.10\u0026thinsp;\u0026plusmn;\u0026thinsp;10.15 years; and 51.43% were male. The cumulative follow-up was 638.54 person-years. Guardian relationship was spouse (30.71%) or parents (42.32%). 30.89% had a pre-study hospitalization history. Patients were categorized as regular (25.54%), irregular (50.71%), or discontinuation (23.75%) groups. Significant differences were found among adherence groups regarding pre-study hospitalization history, treatment phase, and adverse reactions (all p\u0026thinsp;\u0026lt;\u0026thinsp;0.01; Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e Baseline Characteristics of Hospitalization in Community-Dwelling Schizophrenia Patients Treated with Long-Acting Injectable Antipsychotics\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;560)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRegular treatment group(n\u0026thinsp;=\u0026thinsp;143)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eIrregular treatment group(n\u0026thinsp;=\u0026thinsp;284)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eDiscontinuation group(n\u0026thinsp;=\u0026thinsp;133)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eF/χ\u003csup\u003e2\u003c/sup\u003e value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge, years(Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e560(38.10\u0026thinsp;\u0026plusmn;\u0026thinsp;10.15)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e143(38.92\u0026thinsp;\u0026plusmn;\u0026thinsp;10.19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e284(38.23\u0026thinsp;\u0026plusmn;\u0026thinsp;10.26)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e133(36.94\u0026thinsp;\u0026plusmn;\u0026thinsp;9.84)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.259\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHousehold registration status, n (%)]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.942\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLocal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e98(17.50)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27(18.88)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e53(18.66)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e18(13.53)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNon-local\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e462(82.50)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e116(81.12)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e231(81.34)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e115(86.47)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003egender, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.942\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e288(51.43)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e75(52.45)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e146(51.41)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e67(50.38)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e272(48.57)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e68(47.55)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e138(48.59)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e66(49.62)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEducation level, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.982\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eJunior college and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e143(25.54)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23(23.96)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35(27.34)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e85(25.30)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSenior high school/technical secondary school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e284(50.71)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e49(51.04)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e64(50.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e171(50.89)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eJunior high school and below\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e133(23.75)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24(25.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e29(22.66)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e80(23.81)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarital status, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.466\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e236(42.14)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e63(44.06)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e122(42.96)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e51(38.35)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUnmarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e286(51.07)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e68(47.55)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e142(50.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e76(57.14)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDivorced or widowed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e38(6.79)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12(8.39)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20(7.04)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6(4.51)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmployment status, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.743\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmployed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e212(37.86)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e58(40.56)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e105(36.97)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e49(36.84)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUnemployed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e272(48.57)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e63(44.06)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e144(50.70)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e65(48.87)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStudent or other\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e76(13.57)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22(15.38)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35(12.32)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e19(14.29)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRelationship of guardian to patient, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e12.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.142\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSpouse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e172(30.71)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e45(31.47)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e87(30.63)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e40(30.08)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParent\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e237(42.32)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e58(40.56)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e120(42.25)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e59(44.36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChild\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e27(4.82)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6(4.20)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17(5.99)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4(3.01)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSibling\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e99(17.68)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e29(20.28)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e52(18.31)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e18(13.53)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOther\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e25(4.46)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5(3.50)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8(2.82)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e12(9.02)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDuration of illness, years, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e6.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.160\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e0~\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e102(18.21)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e26(18.18)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e43(15.14)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e33(24.81)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6~\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e151(26.96)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e35(24.48)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e80(28.17)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e36(27.07)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e10\u0026thinsp;~\u0026thinsp;42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e307(54.82)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e82(57.34)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e161(56.69)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e64(48.12)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh-risk status prior to study, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.887\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e528(94.29)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e136(95.10)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e267(94.01)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e125(93.98)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e32(5.71)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7(4.90)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17(5.99)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e8(6.02)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePre-study hospitalization history, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e19.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e387(69.11)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e106(74.13)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e173(60.92)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e108(81.20)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e173(30.89)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e37(25.87)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e111(39.08)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e25(18.80)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTreatment phase at last injection, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e80.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePP1M\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e478(85.36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e143(100.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e205(72.18)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e130(97.74)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePP3M\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e82(14.64)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0(0.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e79(27.82)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3(2.26)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eConcomitant antipsychotic use, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e5.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.658\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e284(50.71)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e68(47.55)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e157(55.28)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e59(44.36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e276(49.29)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e75(52.45)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e127(44.72)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e74(55.64)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAdverse drug reactions, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e79.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e503(89.82)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e143(100.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e267(94.01)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e93(69.92)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e57(10.18)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0(0.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17(5.99)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e40(30.08)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRehospitalization (Outcome), n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e37.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e510(91.07)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e140(97.90)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e266(93.66)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e104(78.20)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e50(8.93)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3(2.10)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18(6.34)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e29(21.80)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"7\"\u003eNote: We compared patient age across the different treatment adherence groups using analysis of variance (ANOVA)\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003e3.2 Reasons for Treatment Discontinuation\u003c/h2\u003e\u003cp\u003eA total of 133 patients discontinued treatment. Adverse drug reactions accounted for 40 cases (30.08%), primarily hyperprolactinemia (n\u0026thinsp;=\u0026thinsp;17) and extrapyramidal symptoms (n\u0026thinsp;=\u0026thinsp;10). Other prevalent reasons included disease relapse (n\u0026thinsp;=\u0026thinsp;42, 31.58%), and relocation (n\u0026thinsp;=\u0026thinsp;32, 24.06%). Among other miscellaneous reasons, the emergence of symptoms (n\u0026thinsp;=\u0026thinsp;23) and hospitalization (n\u0026thinsp;=\u0026thinsp;18) were most frequently noted.(Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCategorization of reasons for treatment discontinuation among patients receiving long-acting injectable antipsychotics(n\u0026thinsp;=\u0026thinsp;133).\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eReason for Discontinuation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003en(%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSpecific causes\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAdverse Drug Reactions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e40(30.08)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eHyperprolactinemia: 17\u003c/p\u003e\u003cp\u003eExtrapyramidal symptoms: 10\u003c/p\u003e\u003cp\u003eSleep disturbances: 5\u003c/p\u003e\u003cp\u003eDizziness or headache: 8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDisease Relapse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e42(31.58)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eEmergence of symptoms: 23\u003c/p\u003e\u003cp\u003eHospitalization: 18\u003c/p\u003e\u003cp\u003eAggressive behavior: 1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedical Record Transfer\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e32(24.06)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMedical Record Transfer: 32\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOther Reasons\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e19(14.29)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePain: 10\u003c/p\u003e\u003cp\u003eNeed for concomitant medications: 4\u003c/p\u003e\u003cp\u003eInaccessibility of healthcare facility: 1\u003c/p\u003e\u003cp\u003eRefusal by family members: 1\u003c/p\u003e\u003cp\u003eRefusal of both oral and LAIs: 2\u003c/p\u003e\u003cp\u003ePhysical illness: 1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003e3.3 Univariate and Multivariate Analysis of Rehospitalization\u003c/h2\u003e\u003cp\u003eDuring the follow-up period, 50 patients (8.93%) were rehospitalized, corresponding to an overall incidence rate of 7.83 per 100 person-years. The Log-rank test showed a statistically significant difference in rehospitalization rates among groups with different treatment adherence patterns(χ\u003csup\u003e2\u003c/sup\u003e=33.60, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001;\u003csup\u003e,Fig.\u0026nbsp;2\u003c/sup\u003e). Univariate analysis showed significant associations between rehospitalization and employment status, guardian relationship, pre-study hospitalization history, adverse reactions, and treatment regularity (all p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Multivariate Cox analysis identified guardian relationship (parents vs. spouse: HR\u0026thinsp;=\u0026thinsp;2.16, 95%CI: 1.06\u0026ndash;4.42), pre-study hospitalization history (yes vs. no: HR\u0026thinsp;=\u0026thinsp;2.66, 95%CI: 1.49\u0026ndash;4.75), and treatment regularity (Discontinuation vs. Regular: HR\u0026thinsp;=\u0026thinsp;8.64, 95%CI: 2.62\u0026ndash;28.47) as independent predictors. No significant interaction was found between pre-study hospitalization history and treatment regularity (χ\u0026sup2;=0.55, p\u0026thinsp;=\u0026thinsp;0.759; Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e and Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e ).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eUnivariate Analysis of Hospitalization in Community-Dwelling Patients with Schizophrenia Receiving Long-Acting Injectable Antipsychotics\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;560)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRehospitalization group(n\u0026thinsp;=\u0026thinsp;50)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNon-hospitalized group(n\u0026thinsp;=\u0026thinsp;510)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u003cem\u003e/t\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge, years(Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e38.10\u0026thinsp;\u0026plusmn;\u0026thinsp;10.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e33.68\u0026thinsp;\u0026plusmn;\u0026thinsp;10.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e38.53\u0026thinsp;\u0026plusmn;\u0026thinsp;10.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.25\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHousehold registration, n (%)]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.380\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLocal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e98(17.50)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11(11.22)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e87(88.78)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNon-local\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e462(82.50)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e39(8.44)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e423(91.56)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003egender, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.330\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e288(51.43)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e29(10.07)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e259(89.93)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e272(48.57)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21(7.72)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e251(92.28)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEducation level, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.626\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eJunior college and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e96(17.14)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8(8.33)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e88(91.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSenior high school/technical secondary school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e128(22.86)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9(7.03)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e119(92.97)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eJunior high school and below\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e336(60.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e33(9.82)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e303(90.18)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarital status, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.098\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e236(42.14)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15(6.36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e221(93.64)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUnmarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e286(51.07)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e29(10.14)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e257(89.86)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDivorced or widowed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e38(6.79)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6(15.79)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e32(84.21)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmployment status, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e8.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.016\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmployed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e212(37.86)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12(5.66)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e200(94.34)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUnemployed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e272(48.57)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e34(12.50)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e238(87.50)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStudent or other\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e76(13.57)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4(5.26)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e72(94.74)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRelationship of guardian to patient, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.011\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSpouse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e172(30.71)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10(5.81)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e162(94.19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParent\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e237(5.89)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e33(13.92)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e204(86.08)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChild\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e27(4.82)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2(7.41)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e25(92.59)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSibling\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e99(17.68)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4(4.04)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e95(95.96)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOther\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e25(4.46)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1(4.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e24(96.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDuration of illness, years, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.428\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e0~\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e102(18.21)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6(5.88)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e96(94.12)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6~\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e151(26.96)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13(8.61)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e138(91.39)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e10\u0026thinsp;~\u0026thinsp;42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e307(54.82)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e31(10.10)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e276(89.90)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh-risk status prior to study, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.294\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e528(94.29)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e45(8.52)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e483(91.48)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e32(5.71)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5(15.63)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27(84.38)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePre-study hospitalization history, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e9.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e387(69.11)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e25(6.46)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e362(93.54)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e173(30.89)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e25(14.45)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e148(85.55)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTreatment phase at last injection, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.026\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePP1M\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e478(85.36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e48(10.04)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e430(89.96)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePP3M\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e82(14.64)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2(2.44)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e80(97.56)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eConcomitant antipsychotic use, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.320\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e284(50.71)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22(7.75)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e262(92.25)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e276(49.29)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28(10.14)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e248(89.86)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAdverse drug reactions, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e503(89.82)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e37(7.36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e466(92.64)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e57(10.18)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13(22.81)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e44(77.19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePP-LAI treatment adherence,n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e37.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRegular treatment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e143(25.54)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3(2.10)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e140(97.90)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIrregular treatment group\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e284(50.71)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18(6.34)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e266(93.66)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDiscontinuation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e133(23.75)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e29(21.80)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e104(78.20)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"6\"\u003eNote: a Comparison of age between hospitalized and non-hospitalized groups used t-test\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCox Survival Analysis of Hospitalization in Community-Dwelling Schizophrenia Patients Receiving Long-Acting Injectable Antipsychotics\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cem\u003eβ\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eSE\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003eWaldχ\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eHazard Ratio (HR)(95%CI)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRelationship of guardian to patient\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.043\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSpouse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParent\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.034\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.16(1.06\u0026ndash;4.42)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChild\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.651\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.42(0.31\u0026ndash;6.52)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSibling\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.525\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.69(0.21\u0026ndash;2.19)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOther\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.678\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.65(0.08\u0026ndash;5.10)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePre-study hospitalization history\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e10.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eno\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eyes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e10.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.66(1.49\u0026ndash;4.75)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePP-LAI treatment adherence\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e32.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRegular treatment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIrregular treatment group\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.369\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.76(0.51-6.00)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDiscontinuation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e12.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e8.64(2.62\u0026ndash;28.47)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTreatment phase at last injection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.121\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePP1M\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePP3M\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-1.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.121\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.31(0.07\u0026ndash;1.36)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarital status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.158\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUnmarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.514\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.71(0.25\u0026ndash;1.99)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDivorced or widowed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.347\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.80(0.53\u0026ndash;6.09)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge, years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.213\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e18\u0026thinsp;~\u0026thinsp;44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e45\u0026ndash;64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.213\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.41(0.14\u0026thinsp;~\u0026thinsp;1.20)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmployment status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.101\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmployed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUnemployed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.051\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.96(1.00-3.86)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStudent or other\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.950\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.04(0.32\u0026ndash;3.33)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAdverse drug reactions, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.217\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.217\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.57(0.77\u0026ndash;3.21)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003e\u003cb\u003e3.4 Sensitivity analyses\u003c/b\u003e​\u003c/h2\u003e\u003cp\u003e\u003cb\u003e​3.4.1 Discontinuation for Specific Reasons​​\u003c/b\u003e\u003c/p\u003e\u003cp\u003eIn the multivariate Cox model adjusting for guardian relationship and pre-study hospitalization history, discontinuation due to disease relapse/related reasons (vs. regular treatment: HR\u0026thinsp;=\u0026thinsp;19.82, 95% CI: 5.91\u0026ndash;66.47) and a history of hospitalization within the 3 years prior to the study (yes vs. no: HR\u0026thinsp;=\u0026thinsp;3.21, 95% CI: 1.59\u0026ndash;6.45) remained independent predictors of rehospitalization. Discontinuation due to ADRs (ADRs vs. Regular: HR\u0026thinsp;=\u0026thinsp;3.23, 95% CI: 0.72 \u0026minus;\u0026thinsp;14.49) and other reasons (other reasons vs. Regular: HR\u0026thinsp;=\u0026thinsp;3.56, 95% CI: 0.79 \u0026minus;\u0026thinsp;15.98) showed a non-significant trend (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eFactors Associated with Rehospitalization Among Patients Discontinuing PP-LAI for Different Reasons\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cem\u003eβ\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eSE\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003eWaldχ\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eHazard Ratio (HR)(95%CI)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePre-study hospitalization history\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e10.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eno\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eyes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e10.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3.21(1.59\u0026ndash;6.45)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eReason for Discontinuation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e34.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRegular treatment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAdverse Drug Reactions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.125\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3.23(0.72\u0026ndash;14.49)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDisease Relapse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e23.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e19.82(5.91\u0026ndash;66.47)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOther Reasons\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.098\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3.56(0.79\u0026ndash;15.98)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e​3.4.2 Subgroup without Pre-Study Hospitalization​​\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAnalysis of the subcohort without pre-study hospitalization history (n\u0026thinsp;=\u0026thinsp;387) revealed a highly significant association between treatment adherence and rehospitalization (χ\u0026sup2; = 23.68, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). No events occurred in the regular treatment group (n\u0026thinsp;=\u0026thinsp;106), whereas 8 and 17 events occurred in the irregular (n\u0026thinsp;=\u0026thinsp;173) and discontinuation (n\u0026thinsp;=\u0026thinsp;108) groups, respectively. A significant dose-response trend of increasing rehospitalization rates was observed across the adherence gradient (Cochran-Armitage test for trend, χ\u0026sup2;trend\u0026thinsp;=\u0026thinsp;21.95, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001; Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eRehospitalization in PP-LAI Patients Without Pre-study hospitalization history, Stratified by Treatment Adherence\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRehospitalization\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNon-hospitalized\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eχ\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePP-LAI treatment adherence, n (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRegular treatment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0(0.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e106(100.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e23.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIrregular treatment group\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8(4.60)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e165(94.40)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDiscontinuation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e17(15.70)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e91(84.30)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cp\u003eNote: The Cochran-Armitage test revealed a significant increasing trend in the proportion of rehospitalizations across the regular, irregular, and discontinuation groups（χ²trend = 21.95, P \u003c 0.001\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThis retrospective cohort study of 560 community-dwelling patients with schizophrenia receiving PP-LAI in Bao'an District, Shenzhen, identified treatment adherence, prior hospitalization history, and the patient-guardian relationship as independent predictors of hospitalization. The most salient finding was the decisive impact of treatment regularity, with the treatment discontinuation group exhibiting an 8.64-fold increased risk compared to the regular treatment group, demonstrating a clear risk gradient.\u003c/p\u003e\u003cp\u003eThis finding robustly validates the fundamental rationale for LAI antipsychotics\u0026mdash;to enhance illness stability and prevent relapse by overcoming adherence challenges inherent to oral regimens, which is consistent with a substantial body of prior research (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). However, the high combined rate of irregular treatment and discontinuation (74.46%) in our cohort underscores the persistent challenges within community mental health services, particularly concerning consistent patient follow-up, proactive management of adverse effects, and sustained patient supervision.\u003c/p\u003e\u003cp\u003eThe primary reasons for discontinuation of PP-LAI, a dopamine D2 receptor antagonist, were adverse drug reactions (ADRs) and disease recurrence (30.08% and 31.58%). Understanding its pharmacologic profile is crucial for developing effective interventions. Its efficacy is mediated primarily through central D2 receptor antagonism (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e), but this action is non-specific and can lead to various side effects. Blockade of D2 receptors in the tuberoinfundibular pathway can induce hyperprolactinemia (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e), while antagonism in the nigrostriatal pathway may cause extrapyramidal symptoms (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). Additionally, antagonism at histamine H1 receptors is associated with sedation and weight gain (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e), and alpha-1 adrenergic receptor blockade can lead to orthostatic hypotension (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). Recurrence during PP-LAI treatment may be related to subtherapeutic drug concentrations, particularly during initiation or towards the end of the dosing interval, leading to insufficient blockade of the mesolimbic dopamine pathway and potential dopamine rebound (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Furthermore, intolerable ADRs, such as akathisia, can themselves act as stressors, potentially precipitating agitation and indirectly contributing to relapse (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eGuided by this mechanistic understanding, a multi-faceted intervention strategy is essential to maximize the benefits of PP-LAI while effectively managing risks. At the clinical level, an individualized treatment approach is paramount, involving comprehensive pre-treatment assessment, adherence to the principle of using the lowest effective dose, regular monitoring of weight, metabolic parameters, and movement disorders, and prompt management of ADRs (e.g., using trihexyphenidyl or aripiprazole to mitigate extrapyramidal symptoms) (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). When switching from oral antipsychotics, ensuring an adequate overlap period and employing correct loading strategies are critical to rapidly achieve steady-state plasma levels. At the public health and community level, strengthening regular follow-up, symptom monitoring, and family education is vital. Establishing clear early warning indicators (e.g., refusal of injection, worsening insomnia) and emergency protocols, alongside promoting the concept of using LAIs early in the illness course for integrated management, can systematically enhance adherence and reduce relapse risk.\u003c/p\u003e\u003cp\u003eOur study also confirms that a history of hospitalization prior to the study period is another independent risk factor, with affected patients having a 2.66-fold higher risk. This easily obtainable metric effectively identifies greater illness severity, chronicity, and potential treatment resistance (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e), a finding consistent with extensive previous literature. As Emsley R et al. suggested, relapse is not merely a return of symptoms but is associated with adverse neuroplastic changes and reduced grey matter volume, leading to significant declines in social function and quality of life, thereby creating a vicious cycle of deterioration (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). This underscores the critical need for intensified monitoring and comprehensive support for this high-risk subgroup, even after initiating LAI treatment.\u003c/p\u003e\u003cp\u003eA noteworthy and somewhat counterintuitive finding was the significantly higher risk of hospitalization (HR\u0026thinsp;=\u0026thinsp;2.16) for patients under the guardianship of their parents compared to those under the guardianship of their spouses. This finding may reflect profound family dynamics and sociological factors. It could indicate underlying demographic differences between these groups; patients with parental guardians might be younger, have shorter illness durations, and their families may lack caregiving experience. Alternatively, aging parents may have diminished capacity for care due to generational gaps or their own health issues. More importantly, compared to the more egalitarian partnership often found in spousal relationships, parent-child guardian dynamics may be associated with higher levels of \"expressed emotion\"\u0026mdash;encompassing criticism, hostility, or emotional over-involvement\u0026mdash;which is a well-established psychosocial risk factor for relapse in schizophrenia (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan additionalcitationids=\"CR36\" citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). The long-term care burden and economic pressure on parents may also impact the quality of support (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). A limitation of this study is the lack of detailed assessment of guardians' age, health status, family functioning, and emotional climate, which leaves room for residual confounding. Thus, the \"parental guardianship\" variable may be a proxy for other unmeasured risk factors, such as greater patient severity or lower socioeconomic status, necessitating further investigation.\u003c/p\u003e\u003cp\u003eCompared to previous studies, our conclusions not only reinforce the central role of treatment adherence and prior history but also hold particular significance due to our cohort's characteristics. The high proportions of non-local residents (82.50%) and unemployed/laid-off individuals (48.57%) accurately reflect the typical scenario and unique challenges of managing mental disorders in communities undergoing rapid urbanization in China. The high rate of treatment irregularity suggests that targeted social support policies and interventions for these mobile and socioeconomically vulnerable populations are key to improving the effectiveness of regional mental health services.\u003c/p\u003e\u003cp\u003eSeveral limitations must be acknowledged. First, the unknown confounding factors may exist. Second, the measurement of key variables, such as the \"guardian relationship,\" was relatively crude, lacking depth. Finally, the sample was drawn from a single district, which may limit the generalizability of the findings and requires cautious external validation.\u003c/p\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eIn summary, this study demonstrates that treatment adherence is the critical factor for preventing hospitalization in community-dwelling patients with schizophrenia treated with LAIs, while a history of prior hospitalization and parental guardianship serve as important markers for identifying high-risk individuals. Our findings imply that successful community-based management cannot rely solely on advanced pharmacotherapy. It necessitates an integrated model that combines standardized medication, proactive community follow-up services, and scientifically-supported family systems.\u003c/p\u003e\u003cp\u003eFuture research should employ prospective designs to elucidate the mechanisms underlying the influence of guardian relationships and to develop targeted family intervention strategies, thereby more effectively reducing hospitalization rates and improving patients' quality of life.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eADRs\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eAdverse Drug Reactions\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eConfidence Interval\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eHR\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eHazard Ratio\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eLAI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eLong-Acting Injectable\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003ePP-LAI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003ePaliperidone Palmitate Long-Acting Injectable\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003ePP1M\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eOnce-Monthly Paliperidone Palmitate\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003ePP3M\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eThree-Monthly Paliperidone Palmitate\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Medical Ethics Committee of Bao\u0026apos;an District Chronic Disease Control Hospital (Approval No: 2024-01). Informed consent was obtained from all participants and their guardians.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable. (This manuscript contains no individual person\u0026rsquo;s data).\u003c/p\u003e\n\u003ch2\u003eCompeting interests\u003c/h2\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003ch2\u003eFunding:\u003c/h2\u003e\n\u003cp\u003eThis work was supported by:\u003c/p\u003e\n\u003cp\u003e\u0026bull; The Shenzhen Science and Technology Program (Grant No. JCYJ20220531091006014).\u003c/p\u003e\n\u003cp\u003e\u0026bull; The 2024 Bao\u0026rsquo;an District Medical and Health Research Project (Grant No. 2024JD230).\u003c/p\u003e\n\u003cp\u003e\u0026bull; The Bao\u0026rsquo;an District Key Medical Discipline (Prevention and Control of Chronic Non-Communicable Diseases).\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eCF L and JL Y contributed equally to this work. CF L, JL Y, and YF G conceived and designed the study. CF L, J C, JL L, WY W, CH L and L Q collected and analyzed the data. CF L and JL Y drafted the manuscript. SL Z, X Y, L Z and YF G critically revised the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003ch2\u003eAcknowledgements:\u003c/h2\u003e\n\u003cp\u003eThe authors thank the community health workers for their assistance in data collection.\u003c/p\u003e\n\u003ch2\u003eAvailability of data and materials:\u003c/h2\u003e\n\u003cp\u003eThe datasets generated and/or analysed during the current study are not publicly available due to containing information that could compromise the privacy of patients with severe mental disorders but are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eKeepers GA, Fochtmann LJ, Anzia JM, Benjamin S, Lyness JM, Mojtabai R, et al. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia. Am J Psychiatry. 2020;177(9):868\u0026ndash;72.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHuang Y, Wang Y, Wang H, Liu Z, Yu X, Yan J, et al. Prevalence of mental disorders in China: a cross-sectional epidemiological study. Lancet Psychiatry. 2019;6(3):211\u0026ndash;24.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAlvarez-Jimenez M, Priede A, Hetrick SE, Bendall S, Killackey E, Parker AG, et al. Risk factors for relapse following treatment for first episode psychosis: a systematic review and meta-analysis of longitudinal studies. Schizophr Res. 2012;139(1\u0026ndash;3):116\u0026ndash;28.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eEmsley R, Chiliza B, Asmal L, Harvey BH. The nature of relapse in schizophrenia. BMC Psychiatry. 2013;13:50.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBighelli I, Rodolico A, Garc\u0026iacute;a-Mieres H, Pitschel-Walz G, Hansen WP, Schneider-Thoma J, et al. Psychosocial and psychological interventions for relapse prevention in schizophrenia: a systematic review and network meta-analysis. Lancet Psychiatry. 2021;8(11):969\u0026ndash;80.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNational Health Commission of the People\u0026rsquo;s Republic of China. The Standard for the Management and Treatment of Severe Mental Disorders (2018 Edition). [中华人民共和国国家卫生健康委员会. 严重精神障碍管理治疗工作规范(2018年版). 北京. 2018. Report No.: 国卫疾控发〔2018〕13号.] (In Chinese).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eJauhar S, Johnstone M, McKenna PJ. Schizophrenia Lancet. 2022;399(10323):473\u0026ndash;86.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMarder SR, Cannon TD, Schizophrenia. N Engl J Med. 2019;381(18):1753\u0026ndash;61.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLacro JP, Dunn LB, Dolder CR, Leckband SG, Jeste DV. Prevalence of and risk factors for medication nonadherence in patients with schizophrenia: a comprehensive review of recent literature. J Clin Psychiatry. 2002;63(10):892\u0026ndash;909.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKane JM, Kishimoto T, Correll CU. Non-adherence to medication in patients with psychotic disorders: epidemiology, contributing factors and management strategies. World Psychiatry. 2013;12(3):216\u0026ndash;26.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCorrell CU, Kim E, Sliwa JK, Hamm W, Gopal S, Mathews M, et al. Pharmacokinetic Characteristics of Long-Acting Injectable Antipsychotics for Schizophrenia: An Overview. CNS Drugs. 2021;35(1):39\u0026ndash;59.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLeucht S, Crippa A, Siafis S, Patel MX, Orsini N, Davis JM. Dose-Response Meta-Analysis of Antipsychotic Drugs for Acute Schizophrenia. Am J Psychiatry. 2020;177(4):342\u0026ndash;53.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBauer A, Berben P, Chakravarthi SS, Chattorraj S, Garg A, Gourdon B, et al. Current State and Opportunities with Long-acting Injectables: Industry Perspectives from the Innovation and Quality Consortium Long-Acting Injectables Working Group. Pharm Res. 2023;40(7):1601\u0026ndash;31.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLi Q, Li X, Ye C, Jia M, Si T. Effectiveness and Safety of Switching from Oral Antipsychotics to Once-Monthly Paliperidone Palmitate (PP1M) in the Management of Schizophrenia: A Systematic Review and Meta-Analysis. CNS Drugs. 2023;37(8):695\u0026ndash;713.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTiihonen J, Mittendorfer-Rutz E, Majak M, Meht\u0026auml;l\u0026auml; J, Hoti F, Jedenius E, et al. Real-World Effectiveness of Antipsychotic Treatments in a Nationwide Cohort of 29 823 Patients With Schizophrenia. JAMA Psychiatry. 2017;74(7):686\u0026ndash;93.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOh S, Byeon SJ, Chung SJ. Characteristics of adverse reactions among antipsychotic drugs using the Korean Adverse Event Reporting System database from 2010 to 2019. J Psychopharmacol (Oxford England). 2022;36(9):1041\u0026ndash;50.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLeucht C, Heres S, Kane JM, Kissling W, Davis JM, Leucht S. Oral versus depot antipsychotic drugs for schizophrenia\u0026ndash;a critical systematic review and meta-analysis of randomised long-term trials. Schizophr Res. 2011;127(1\u0026ndash;3):83\u0026ndash;92.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKishimoto T, Hagi K, Nitta M, Leucht S, Olfson M, Kane JM, et al. Effectiveness of Long-Acting Injectable vs Oral Antipsychotics in Patients With Schizophrenia: A Meta-analysis of Prospective and Retrospective Cohort Studies. Schizophr Bull. 2018;44(3):603\u0026ndash;19.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eG\u0026uuml;ndoğmuş İ, Aydin MB, \u0026Ouml;z S, Taş\u0026ccedil;i AB, Uzun \u0026Ouml;. Clinical and demographic factors associated with early relapse in patients with schizophrenia: a naturalistic observation study. Int Clin Psychopharmacol. 2021;36(6):288\u0026ndash;95.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRichter D, Hoffmann H. Independent housing and support for people with severe mental illness: systematic review. Acta Psychiatr Scand. 2017;136(3):269\u0026ndash;79.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePeng X, Wang S, Bi J, You L, Zhou Z, Tan W, et al. Gender differences in socio-demographics, clinical characteristic and quality of life in patients with schizophrenia: A community-based study in Shenzhen. Asia Pac Psychiatry. 2021;13(2):e12446.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOrganization WH. International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). 2019. Report No.: ICD-10-CM FY2025.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eEffect of paliperidone palmitate treatment on disease family burden and rehabilitation effect in community schizophrenic patients. Shanghai Journal ofPreventive Medicine. 2023;35(07):684\u0026ndash;8.[葛晓蕾, 张伟波, 陈春梅, 何思源, 赵苗苗, 金金, 棕榈酸帕利哌酮注射液治疗社区精神分裂症患者的效果分析. 上海预防医学. 2023;35(07):684\u0026ndash;8.] (In Chinese).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGefvert O, Eriksson B, Persson P, Helldin L, Bj\u0026ouml;rner A, Mannaert E, et al. Pharmacokinetics and D2 receptor occupancy of long-acting injectable risperidone (Risperdal Consta) in patients with schizophrenia. Int J Neuropsychopharmacol. 2005;8(1):27\u0026ndash;36.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePerlstein I, Merenlender Wagner A, Elgart A, Zandvliet AS, Hellmann F, Lin Y, et al. Population Pharmacokinetic Modeling of TV-46000, a Risperidone Long-Acting Subcutaneous Antipsychotic for the Treatment of Patients with Schizophrenia. Neurol therapy. 2025;14(3):829\u0026ndash;48.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChouinard G, Samaha AN, Chouinard VA, Peretti CS, Kanahara N, Takase M, et al. Antipsychotic-Induced Dopamine Supersensitivity Psychosis: Pharmacology, Criteria, and Therapy. Psychother Psychosom. 2017;86(4):189\u0026ndash;219.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLin X, Siafis S, Tian J, Wu H, Qin M, Correll CU, et al. Antipsychotic-Related Prolactin Changes: A Systematic Review and Dose-Response Meta-analysis. CNS Drugs. 2025;39(10):937\u0026ndash;47.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAbe Y, Yagishita S, Sano H, Sugiura Y, Dantsuji M, Suzuki T, et al. Shared GABA transmission pathology in dopamine agonist- and antagonist-induced dyskinesia. Cell Rep Med. 2023;4(10):101208.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eYoshida K, Bies RR, Suzuki T, Remington G, Pollock BG, Mizuno Y, et al. Tardive dyskinesia in relation to estimated dopamine D2 receptor occupancy in patients with schizophrenia: analysis of the CATIE data. Schizophr Res. 2014;153(1\u0026ndash;3):184\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLeucht S, Schneider-Thoma J, Burschinski A, Peter N, Wang D, Dong S, et al. Long-term efficacy of antipsychotic drugs in initially acutely ill adults with schizophrenia: systematic review and network meta-analysis. World psychiatry: official J World Psychiatric Association (WPA). 2023;22(2):315\u0026ndash;24.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNkemjika S, Singh S, Wayne K, Oforeh K, Saha A. Risperidone induced hypotension: A case report and literature review. J Natl Med Assoc. 2022;114(6):621\u0026ndash;3.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKane JM. Lessening the Side Effect Burden to Improve Adherence Among Individuals With Schizophrenia. J Clin Psychiatry. 2021;82(2).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGrygiel-G\u0026oacute;rniak B, Puszczewicz M. A review on irisin, a new protagonist that mediates muscle-adipose-bone-neuron connectivity. Eur Rev Med Pharmacol Sci. 2017;21(20):4687\u0026ndash;93.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNaguy A, Al-Khadhari S. Anismus-A Very Unusual Extrapyramidal Side Effect of Paliperidone Palmitate in an Adolescent with Schizo-Affective Disorder. Psychopharmacol Bull. 2024;54(3):100\u0026ndash;2.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDeng M, Zhai S, Ouyang X, Liu Z, Ross B. Factors influencing medication adherence among patients with severe mental disorders from the perspective of mental health professionals. BMC Psychiatry. 2022;22(1):22.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBorojevic N, Dawud M, Xiao J, Yun Y. Long-acting injectable paliperidone palmitate induced severe cutaneous allergic reaction in a patient with first episode delusional disorder tolerating oral paliperidone regimen: a case report. BMC Psychiatry. 2022;22(1):734.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSchoretsanitis G, Haen E, Piacentino D, Conca A, Endres K, Carpi F, et al. Pharmacokinetic Correlates of Once-Monthly Paliperidone Palmitate-Related Adverse Drug Reactions. Clin Pharmacokinet. 2021;60(12):1583\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGou L, Su R, Guo R, Li L, Li J, Zhou B, et al. Efficacy and safety of paliperidone palmitate 1-month formulation (PP1M) for schizophrenia in southwestern China. BMC Psychiatry. 2025;25(1):342.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychiatry","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bpsy","sideBox":"Learn more about [BMC Psychiatry](http://bmcpsychiatry.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bpsy/default.aspx","title":"BMC Psychiatry","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Schizophrenia, Paliperidone Palmitate, Long-Acting Injectable Antipsychotics, Rehospitalization, Treatment Adherence, Retrospective Cohort Study, Risk Factors, Community Mental Health","lastPublishedDoi":"10.21203/rs.3.rs-7943770/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7943770/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eWhile long-acting injectable paliperidone palmitate (PP-LAI) improves treatment adherence in schizophrenia, rehospitalization risks persist under community management. This study identified factors influencing rehospitalization in community-dwelling schizophrenia patients receiving PP-LAI.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA retrospective cohort study included 560 patients from 124 communities in Shenzhen (16 September 2022\u0026ndash;15 September 2024). Data were extracted from medical databases. The primary outcome was rehospitalization due to psychiatric relapse. Cox regression models analyzed influencing factors.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eDuring a median follow-up of 14 months, 50 patients (8.93%) were rehospitalized (rate: 7.83 per 100 person-year). Treatment discontinuation (n\u0026thinsp;=\u0026thinsp;133) was primarily due to adverse drug reactions (30.08%) and disease relapse (31.58%). Cox analysis identified guardian type (parents vs. spouse: HR\u0026thinsp;=\u0026thinsp;2.16, 95% CI: 1.06\u0026ndash;4.42), pre-study hospitalization history (yes vs. no: HR\u0026thinsp;=\u0026thinsp;2.66, 95% CI: 1.49\u0026ndash;4.75), and treatment discontinuity (discontinuation vs. regular treatment: HR\u0026thinsp;=\u0026thinsp;8.64, 95% CI: 2.62\u0026ndash;28.47) as independent risk factors for rehospitalization.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eTreatment discontinuation is the strongest predictor of rehospitalization in PP-LAI-treated schizophrenia patients. Prior hospitalization and guardianship by parents also significantly increase risks. Clinical strategies should prioritize maintaining treatment continuity, proactively managing side effects, and strengthening family/community support for high-risk groups to reduce the risk of rehospitalization.\u003c/p\u003e\u003ch2\u003eTrial registration:\u003c/h2\u003e\u003cp\u003eNot applicable. (This is a retrospective observational study and does not involve a clinical trial requiring prospective registration).\u003c/p\u003e","manuscriptTitle":"Rehospitalization Risk in Community-Dwelling Schizophrenia Patients Receiving Paliperidone Palmitate: A Retrospective Cohort Study in Urban China","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-11 16:44:17","doi":"10.21203/rs.3.rs-7943770/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-11-25T09:57:03+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-24T05:34:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"163987116443276755217694736898123326039","date":"2025-11-04T03:52:21+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-03T03:37:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"308467410459504546632608811197776956576","date":"2025-11-03T01:08:14+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-31T04:26:39+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-28T18:40:42+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-25T11:30:02+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-25T11:29:37+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychiatry","date":"2025-10-25T01:30:45+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychiatry","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bpsy","sideBox":"Learn more about [BMC Psychiatry](http://bmcpsychiatry.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bpsy/default.aspx","title":"BMC Psychiatry","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0e98e720-16a0-4efe-aaae-9497d4d31bdc","owner":[],"postedDate":"November 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-12-15T16:08:03+00:00","versionOfRecord":{"articleIdentity":"rs-7943770","link":"https://doi.org/10.1186/s12888-025-07707-1","journal":{"identity":"bmc-psychiatry","isVorOnly":false,"title":"BMC Psychiatry"},"publishedOn":"2025-12-13 15:58:44","publishedOnDateReadable":"December 13th, 2025"},"versionCreatedAt":"2025-11-11 16:44:17","video":"","vorDoi":"10.1186/s12888-025-07707-1","vorDoiUrl":"https://doi.org/10.1186/s12888-025-07707-1","workflowStages":[]},"version":"v1","identity":"rs-7943770","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7943770","identity":"rs-7943770","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}