Which of the following is a relapse risk factor that should be addressed in treatment planning?

• A. Substance use
• B. Regular exercise
• C. High social support
• D. Adequate sleep

Answer: (A)

Relapse risk factors in schizophrenia are factors that increase the likelihood of symptoms returning, and treatment planning should target them to stabilize a patient. Substance use stands out as a relapse risk because it can directly trigger psychotic symptoms, worsen overall illness severity, and interfere with antipsychotic adherence and effectiveness. When someone uses drugs or alcohol, it can destabilize medication routines, heighten stress on the brain, and lead to a rapid deterioration in functioning, making relapse more likely. Therefore, addressing substance use—through integrated treatment, careful coordination with psychiatry, and evidence-based approaches like motivational interviewing or addiction services—is essential to reduce relapse risk and support long-term stability.

In contrast, factors like regular exercise, high social support, and adequate sleep generally act as protective elements that support recovery and lower relapse risk. Encouraging physical activity, strengthening support networks, and ensuring good sleep are important parts of a comprehensive plan, but they do not represent relapse-driving factors the way substance use does.