Nonadherence to medication four years after a first episode of psychosis and associated risk factors

Psychiatric Services : a Journal of the American Psychiatric Association
Michele HillEadbhard O'Callaghan

Abstract

This study examined concurrent associations and predictors at first indication of nonadherence to antipsychotic medication four years after a first episode of psychosis. A prospective cohort of 171 patients in urban Ireland with a first episode of psychosis was followed up four years after inception (follow-up primary analysis, N=84; secondary analysis, N=104). At the four-year follow-up 76% were adherent and 24% were not. Nonadherence was concurrently associated with substance misuse (p<.01), increased symptomatology (p<.01), less insight (p=.01), lower global functioning (p<.01), and negative attitudes toward medication (p<.01). Compared with other patients, those who were nonadherent had more readmissions (p=.01). Predictors of future nonadherence were substance misuse (p=.02) and duration of untreated psychosis (p=.04). This prospective investigation confirms previous cross-sectional studies. The association between longer duration of untreated psychosis and nonadherence warrants further research because it could be interpreted as further evidence of the importance of early intervention.

Citations

May 7, 2015·Revista brasileira de psiquiatria : orgão oficial da Associação Brasileira de Psiquiatria, Asociación Psiquiátrica de la América Latina·Emilie LeclercElisa Brietzke
Feb 4, 2019·Acta Psychiatrica Scandinavica·J-G DaneaultJ L Shah
Nov 30, 2019·CNS Spectrums·Charles DempseyKelly Kruger
Oct 21, 2016·Early Intervention in Psychiatry·Rafal A H YeisenStein Opjordsmoen
Oct 12, 2016·Early Intervention in Psychiatry·Robin E GearingJames Mandiberg
Jan 1, 2014·The Journal of Nervous and Mental Disease·Kit Wa Sherry ChanYu Hai Eric Chen

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