Relapse in patients with serious mental disorders during the COVID-19 outbreak: a retrospective chart review from a community mental health center

An outbreak, such as the coronavirus disease 2019 , may facilitate relapse of psychotic disorders through outcome, such as social distancing, lockdown or change in the priority of health services [1].Besides the effects of the outbreak, lack of insight, non-adherence to treatment, poor social and cognitive functioning observed in psychotic disorders may make it difficult to maintain treatment [2].Non-adherence to treatment is a major risk factor for relapse in individuals with schizophrenia or bipolar disorder [3,4].Using long-acting injectable antipsychotics (LAIs) may be a solution against the risk of relapse under outbreak conditions.Community mental health centers (CMHCs) may be protective against the risk of relapse, but their delivery of care is also affected by the outbreak.They might have to develop and implement new interventions as the outbreak commands [5], but few evidence exists to design a relevant plan for relapse prevention [6] and to apply a sustainable clinical practice [7].In this background, we aimed to detect the relapse rate of patients registered at Etimesgut CMHC, Ankara, to investigate the basic characteristics of patients who experienced relapse during the first trimester (from 10th of March to 10th of June) of the COVID-19 outbreak in Turkey, and to compare main findings with the same period in 2019 as being suggested by Moreno et al. [7].Our CMHC had been closed between 23 March and 13 April 2020 because the team was initially assigned to Etimesgut State Hospital for the outbreak until mid-April.