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

Hill, Michele and Crumlish, Niall and Whitty, Petter and Clarke, Mary and Browne, Stephen and Kamali, Moayyad and Kinsella, Anthony and Waddington, John L and Larkin, Conall and O'Callaghan, Eadbhard (2010) Nonadherence to medication four years after a first episode of psychosis and associated risk factors. Psychiatric Services , 61 , (2) , pp. 189-92.

OBJECTIVES: This study examined concurrent associations and predictors at first indication of nonadherence to antipsychotic medication four years after a first episode of psychosis.

METHODS: 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).

RESULTS: 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).

CONCLUSIONS: 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.

 

Item Type:Article
Date:February 2010
Page Range:pp. 189-92
Volume:61
Number:2
EndNote:View
Accession Number:HRB (Not in collection)
Subjects:J Health care, prevention and rehabilitation > Care by type of problem > Mental health care
VA Geographic area > Europe > Ireland
G Health and disease > Substance related disorder > Dual diagnosis (comorbidity)

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