Psoriasis is a chronic immune-mediated disorder characterized by skin inflammation and multiple comorbidities, 1,2 including cardiovascular disease, and it can compromise the patient's quality of life. [1][2][3][4][5] Patients with psoriasis commonly experience stigmatization, poor self-esteem and social rejection because of their skin lesions. [6][7][8][9] Recent studies have reported an increased incidence of various psychiatric diseases, including anxiety and depressive disorder, among patients with psoriasis. [10][11][12] Suicidality conceptually includes suicidal ideation (thoughts about death or engaging in behaviour to kill oneself), suicide attempt (self-harm with at least some intent to kill oneself) and completed suicide. 13 According to the World Health Organization, approximately 700,000 people commit suicide annually. 14 Suicide is also emerging as a serious social health problem in South Korea, which has one of the highest suicide rates among the Organization for Economic Co-operation and Development countries. 15 In 2019, suicide ranked first among the causes of death in those aged 10-39 years and second in those aged 40-59 years in South Korea. 16
Objectives: Early pharmacologic intervention is considered necessary for improving the prognosis in patients with first-episode schizophrenia (FES). However, few nationwide population-based studies have focused on early medication adherence. We investigated the status of early adherence to antipsychotics and the effect of early adherence on later clinical outcomes in FES.Methods: We used data from the South Korean Health Insurance Review Agency database (2009-2021). We selected 28,931 patients with FES who had a prescription record of at least one antipsychotic medication within 180 days after their diagnosis. We measured early medication adherence using the medication possession ratio (MPR) and compared demographic characteristics and results of psychiatric hospitalization between the adherence group (0.6≤MPR<1.1) and the non-adherence group (MPR<0.6).Results: The average early medication adherence was 0.82 by MPR, and the non-adherence group accounted for 15.6% of all subjects. From 1 to 2 years after diagnosis, the adherence group showed a higher number of psychiatric hospitalizations per hospitalized patient but a shorter duration than the non-adherence group. Additionally, the proportion of patients who experienced psychiatric hospitalizations was smaller in the adherence group.Conclusion: In patients with FES, early medication adherence is associated with lower rates of psychiatric hospitalization and shorter hospitalization durations.
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