A relapse prevention model for comorbid schizophrenia and cannabis use disorder in South Africa
Malaza, Matilda Maria
Incidents of users with comorbid schizophrenia and cannabis use disorder experiencing
a relapse have been a cyclic phenomenon for decades in most psychiatric health care
facilities admitting users with such diagnosis. Rehabilitation programmes play a pivotal
role in reducing and preventing relapses and are receiving more attention of late.
Cannabis use and non-adherence to treatment contribute to a relapse for comorbid
schizophrenia and cannabis use disorder users. The purpose of this study was to
develop and describe a relapse prevention model for MHCPs to support users with
comorbid schizophrenia and cannabis use disorder and their caregivers in the
prevention of a relapse.
The study was conducted in two phases, namely empirical and theory generating. Data
was collected by means of semi-structured interviews with fourteen users and their
thirteen caregivers. A caregiver for the fourteenth user declined to participate. The data
was analysed using Van Kaam’s (1984) data analysis method.
The users with comorbid schizophrenia and cannabis use disorder experienced effects
of cannabis that led to a relapse, and identified factors maintaining cannabis use and
factors discouraging cannabis use. In terms of effects of cannabis that led to a relapse,
the caregivers were burdened by objective cognitive relapse symptoms of psychosis by
the users. In respect of factors maintaining cannabis use, the caregivers experienced
the burden of social effects due to illness. Factors discouraging cannabis use, included
institutional factors, e.g. psychiatric treatment, rehabilitation, support, as well as spiritual
and traditional help. In phase 2 the researcher developed a relapse prevention model for use in nursing
practice, education and research by MHCPs to support users with comorbid
schizophrenia and cannabis use disorder and their caregivers.
The findings suggest that help, support, guidance and mental health education, coping
skills, cognitive behaviour therapy and lifestyle modification are intervention strategies
that are crucial in relapse prevention. The model would enable MHCPs to support users
with comorbid schizophrenia and cannabis use disorder, including measures to support
their caregivers in South Africa.
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