A patient with schizophrenia relapses after discharge. What is the most likely reason?

NORCET 10 Prelims-2026

Mental Health Nursing

Medium

Appeared in: NORCET 10 Prelims-2026

Explanation

Schizophrenia is a chronic illness requiring long-term management, and relapse is common after discharge.
Lack of continuity of care refers to the breakdown in coordinated care between the hospital and community settings.
This breakdown leads to medication non-adherence, missed appointments, and insufficient support, which are primary drivers of relapse.
Continuity of care is associated with higher treatment adherence and reduced hospital service utilization (SRC_1).

Option B: Primary prevention aims to stop a disease before it ever occurs. It is not relevant to a patient who has already been diagnosed with schizophrenia and is experiencing a relapse.
Option C: Adequate follow-up is a component of good continuity of care and is a key factor in preventing relapse, not causing it. The question asks for a reason for relapse.
Option D: Early intervention focuses on treating a disorder at its initial onset to improve long-term outcomes (SRC_2). It is a secondary prevention strategy and not a cause of relapse in a patient with an established diagnosis.

Visual 1: Flowchart: Illustrating the ideal 'Continuity of Care' pathway from hospital discharge to community support for a patient with schizophrenia. Show key handoff points: discharge planning, first follow-up appointment, medication management, therapy, and crisis support.
Visual 2: Infographic: Comparing Primary, Secondary, and Tertiary prevention with clear examples for mental health conditions like schizophrenia.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Relapse prevention in schizophrenia and levels of prevention in mental health in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Nurses play a pivotal role in discharge planning and ensuring continuity of care. This includes patient and family education, coordinating with community case managers, and scheduling the first follow-up appointment before the patient leaves the hospital.
A key nursing intervention is to assess the patient's understanding of their illness, medications, and the importance of follow-up. Cognitive deficits common in schizophrenia can interfere with a patient's ability to manage their own care (SRC_1).
What if? If the patient had a dedicated case manager who visited them in the hospital before discharge and accompanied them to their first outpatient appointment, the risk of relapse would be significantly lower. This 'warm handoff' is a best practice in ensuring continuity of care.

How to Approach the Question

First, identify the core concept: The question asks for the cause of a negative outcome (relapse) in a patient with a chronic illness (schizophrenia).
Analyze the options in the context of cause vs. prevention. Ask yourself for each option: 'Does this cause a relapse, or does it prevent one?'
Eliminate options that are preventative measures. 'Adequate follow-up' and 'Early intervention' are clearly actions taken to prevent negative outcomes.
Differentiate between the remaining options. 'Primary prevention' is incorrect because the patient already has the disease. 'Lack of continuity of care' directly addresses the failure of the system to support the patient post-discharge, making it the most logical cause for relapse.
Confirm your answer by recalling that schizophrenia requires continuous, long-term management, and any break in this management chain is a major risk factor.

Concept Tested & Keywords

Concept Tested: Relapse prevention in schizophrenia and levels of prevention in mental health.
Stem keywords: schizophrenia, relapse, discharge
Lead-in keywords: most likely reason

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