Schizophrenia is a prevalent and severe mental disorder characterized by a high rate of disability and relapse. While certain studies on the influencing factors of schizophrenia relapse have been conducted in western countries or regions, the applicability of their findings to the Chinese patient population is limited due to differences in cultural backgrounds and variations in patient demographics. Therefore, identifying the local factors that influence relapse in the Chinese context is of great significance.

To explore the influencing factors for relapse in patients with schizophrenia in China, and to provide evidence-based basis for clinical intervention.

Studies on relapse risk factors in Chinese patients with schizophrenia were collected by searching the databases of CNKI, Wanfang Data, VIP, CBM, PubMed, Embase, Cochrane Library, Ovid Medline and Web of Science. The retrieval time was from building the database to May 18, 2025. The literature was screened based on predefined inclusion and exclusion criteria, followed by data extraction and quality assessment of the selected studies. A Meta-analysis was conducted using RevMan 5.4.

The analysis included 21 studies, comprising 6 496 subjects, and 14 influencing factors were extracted. Results indicated that several factors significantly increased the risk of relapse: no spouse (I²=71%, OR=1.71, 95%CI=1.26-2.32, P<0.01), long disease course (I²=30%, OR=1.25, 95%CI=1.07-1.45, P<0.01), family history (I²=48%, OR=2.60, 95%CI=2.01-3.35, P<0.01), drinking history (I²=0, OR=2.22, 95%CI=1.60-3.08, P<0.01), paranoid type (I²=83%, OR=3.47, 95%CI=1.90-6.34, P<0.01), poor medication adherence (I²=92%, OR=3.59, 95%CI=2.44-5.29, P<0.01), negative life events (I²=93%, OR=2.81, 95%CI=1.35-5.87, P<0.01), positive mood swings (I²=84%, OR=2.66, 95%CI=1.31-5.38, P<0.01), lack of family support (I²=79%, OR=2.61, 95%CI=1.71-3.99, P<0.01) and unemployment/out of school (I²=0, OR=2.52, 95%CI=2.09-3.04, P<0.01). Protective factors included high level of social support (I²=0, OR=0.19, 95%CI=0.13-0.28, P<0.01) and regular follow-up appointments (I²=9%, OR=0.28, 95%CI=0.17-0.46, P<0.01). Subgroup analysis suggested that regular follow-up appointments (I²=9%, OR=0.28, 95%CI=0.17-0.46, P<0.01) and unemployment/out of school (I²=0, OR=2.52, 95%CI=2.09-3.04, P<0.01) were unique influencing factors for community patients.

Relapse of schizophrenia is influenced by a combination of factors, and the risk of relapse needs to be reduced through multidimensional interventions such as strengthening medication management, improving family support, and optimizing community follow-up.

精神分裂症是一种常见的重性精神障碍，具有高致残率、高复发率的特征。目前，西方国家/地区已对精神分裂症复发的影响因素开展了一定探索，但由于中西方文化背景存在差异，不同患者群体的复发影响因素呈现异质性，导致西方国家/地区的研究结论在我国患者群体中的适用性存在局限。因此，明确我国本土精神分裂症复发的影响因素具有重要意义。

探讨中国精神分裂症患者复发的影响因素，为临床干预提供循证依据。

检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库（CBM）、PubMed、Embase、Cochrane Library、Ovid Medline、Web of Science等数据库中有关中国精神分裂症患者复发影响因素的文献，检索时间设置为建库至2025-05-18。按照纳入与排除标准筛选文献，并对纳入文献进行数据提取和质量评价，使用RevMan 5.4软件进行Meta分析。

纳入21篇研究，涉及6 496例研究对象，提取到14个影响因素。Meta分析结果显示，复发危险因素包括无配偶（I²=71%，OR=1.71，95%CI=1.26~2.32，P<0.01）、病程长（I²=30%，OR=1.25，95%CI=1.07~1.45，P<0.01）、精神疾病家族史（I²=48%，OR=2.60，95%CI=2.01~3.35，P<0.01）、饮酒史（I²=0，OR=2.22，95%CI=1.60~3.08，P<0.01）、偏执型精神分裂症（I²=83%，OR=3.47，95%CI=1.90~6.34，P<0.01）、服药依从性差（I²=92%，OR=3.59，95%CI=2.44~5.29，P<0.01）、负性生活事件（I²=93%，OR=2.81，95%CI=1.35~5.87，P<0.01）、情绪波动阳性（I²=84%，OR=2.66，95%CI=1.31~5.38，P<0.01）、家庭支持差（I²=79%，OR=2.61，95%CI=1.71~3.99，P<0.01）、失业/失学（I²=0，OR=2.52，95%CI=2.09~3.04，P<0.01）；保护因素为社会支持水平高（I²=0，OR=0.19，95%CI=0.13~0.28，P<0.01）、定期复诊（I²=9%，OR=0.28，95%CI=0.17~0.46，P<0.01）。亚组分析结果表明，定期复诊（I²=9%，OR=0.28，95%CI=0.17~0.46，P<0.01）、失业/失学（I²=0，OR=2.52，95%CI=2.09~3.04，P<0.01）是社区患者特有的影响因素。

精神分裂症复发受多种因素共同影响，需通过多维度干预（如加强服药管理、改善家庭支持、优化社区随访等）降低复发风险。