Medication compliance is one of the foremost problems affecting neuroleptic efficacy in psychiatric patients. It is a crucial point to dispone of useful instruments that allow us a fiable assessment of patients' medication adherence in order to plan more appropriate therapeutical interventions. The aim of our study was to validade the Portuguese versión of the Medication Adherence Rating Scale (MARS), a concise instrument for assessment of medication compliance in psychosis.A translation-backtranslation of the original scale was elaborated. The sample consisted of 77 psychotic patients according to the DSM-IV criteria. Feasibility and reliability were calculated.The results demonstrated that the MARS has a good internal consistence (Cronbach α = 0,73) and reliability (Pearson's r = 0,76; p < 0,05).These coefficients were similar to those found by the researchers who developed this scale. The MARS scale has proven to be easily applied and may be deemed a valid and reliable measure of compliancy for psychoactive medications.
Background and Aims:We investigated which factors could influence insight in psychosis.Methods:117 in-out patients recruited in the Psychiatric Service of Santa Maria Hospital, Lisbon (Portugal) diagnosed with schizophrenia, schizoaffective and schizophreniform disease, psychosis also drug induced, were evaluated with SAI to asses insight, MARS for medication compliance, WHOQOOL-BREF for Quality of Life, BPRS and PANSS for psychopathological symptoms, I.A test (Reduced Raven's Matrix) for Intellectual Ability. Bivariate correlations were operated using Spearman correlation coefficient (p<0,01). Regression analyses with stepwise ascending regression were computed to assess predictors for insight.Results:We found significant negative correlations between SAI total score and Delusions, Conceptual Disorganization, Hallucinatory Behavior, Suspiciousness, Poor Rapport, Stereotyped Thinking, Somatic Concerns, Unusual Thought Content, Lack of Judgment of Insight of PANSS, Self Neglect of BPRS and Professional State. Positive significant correlation was between SAI and MARS total score. The regression analysis showed negative relations between PANSS Poor Rapport, Suspiciousness, Guilt Feelings, Active Social Avoidance and Insight; positive relation between Depression (PANSS) and Insight.Conclusions:Poor Insight was determined by Poor Rapport and Social Avoidance maybe because patients are less predisposed to compare their situations with the surroundings, showing defensive denial and less criticism towards symptoms. Suspiciousness contributes to poor insight due to distrustful attitude that makes difficult to accept the diagnosis and the idea of being seek. Guilt feelings determine poor insight as they are prodromes of delusions. Depression increases insight as a consequence of the painful feelings that make patients think about their situations.
Aims:Treatment adherence is crucial to the therapeutic success in psychiatric disorders. Evaluating factors involved in treatment adherence will allow to modify treatment strategies for greater compliance. the aim of the study was to evaluate factors involved in treatment adherence, including subjective patients’ satisfaction.Method:The study included in- and outpatients who met the criteria according to DSM-IV TR of schizophrenia, schizophreniform disorder, schizoaffective disorder, delusional disorder, psychosis not otherwise specified, brief psychotic disorder and bipolar disorder. the following questionnaires were applied:1.Demographic and clinical questionnaire;2.Treatment Satisfaction Questionnaire for Medication Version II (TSQM vII);3.Medication Adherence Rating Scale (MARS);4.Schedule for Assessment of Insight (SAI);5.World Health Organization Quality of Life-BREF Scale (WHOQoL-BREF).TSQM vII is a self-reporting questionnaire to assess the major dimensions of patients’ satisfaction with their medication, includes 11 items that make up three specific scales (effectiveness, side-effects and convenience).Results:Twenty patients, between 18 and 65 years of age, were included. an interview was made and the 5 questionnaires were applied. the statistical analysis, using Regression Analysis Stepwise, showed a significant positive correlation between medication adherence, evaluated by MARS, and treatment effectiveness to the patients, evaluated by TSQMvII effectiveness scale (p=0.028). the correlations between the others parameters were not statistically significant.Conclusion:In this study the authors found that the self-experience of treatment effectiveness, which is a major dimension for treatment satisfaction, had a positive correlation with treatment adherence. Strategies to enhance subjective treatment effectiveness are needed to improve medication adherence.
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