Clinical correlates of early medication adherence: West London first episode schizophrenia study

Abstract

At the initiation of drug treatment, attitudes toward medication and insight appear more relevant to medication adherence than side effects. Adherence appears to reflect a complex interaction of influences, which may change over time.

Insight and Self-Stigma in Patients With Schizophrenia

“…This can be explained by the fact that patients more easily recognize how something in general is happening with them, realize changes in social functioning and observe the impact of medication prior to defining positive and negative symptoms as part of illness. These results are consistent with the literature 11,12 . Self-stigma measured with ISMI was much lower than reported earlier by Brohan and GAMIAN group (Croatia was included in the study) 13 ; none of the patients had ISMI above 3 (strong self-stigma), while only 22.8% reported moderate self-stigma.…”

Drug attitude as predictor for effectiveness in first-episode schizophrenia: Results of an open randomized trial (EUFEST)

“…discontinuation of initiated treatment; p<0.001). This corresponds to other studies, in which drug attitude was found as a predictor for drug non-adherence or discontinuation in unselected samples comprising of mainly multiple episode schizophrenia patients (4) as well as in specific samples of first-episode patients (Kampman et al 2002, Mutsatsa 2003, Perkins et al 2006 in the latter of borderline significance). In the sample analyzed here, only one additional significant predictor evolved, depending on the method applied (a lower PANSS-positive score in the logistic regression analysis; p=0.002; sexual side effects as measured by UKU in the Cox-regression analysis; p=0.04).…”

“…Based on theoretical considerations (Perkins 2002, Weiden 2007 and empirical findings, patients' attitude towards drug treatment was suggested to be a factor associated with treatment discontinuation both in unselected samples (mainly multiple episode patients; Lacro et al 2002) and in first-episode patients (Kampman et al 2002, Mutsatsa 2003, Perkins et al 2006. Several scales have been developed for an easy and valid assessment of such attitudes (e.g.…”

“…The indicators included and extracted are as manifold as in multiple episode patients: lower occupational status, substance abuse, psychopathology (more pronounced delusional symptoms and suspiciousness; Verdoux et al 2000), negative attitudes toward drug treatment and lack of insight (Kampmann et al 2002, Mutsatsa et al 2003, poor premorbid (cognitive) and post-acute (executive) functioning, more pronounced (extrapyramidal) side effects (Robinson et al 2002, Perkins et al 2008, lower expectations regarding the need for or effectiveness of general or drug-specific treatment, treatment with first (vs. second) generation antipsychotics (FGAs / SGAs; Perkins et al 2006), hostility and uncooperativeness, involuntary admission (De Haan et al 2007), poor treatment response, low adherence to preceding treatment, poor cognitive functioning, persisting negative or depressive symptoms, ethnicity (Perkins et al 2008), less social support, living alone, refusing drugs at treatment initiation (Rabinovitch et al 2009), and substance abuse (Perkins et al 2008, Miller et al 2009). …”

Religious Beliefs and Their Relevance for Treatment Adherence in Mental Illness: A Review

“…This points to an important role of insight in the context of mental illness. Relative lack of the insight may contribute to worse adherence (Mutsatsa et al 2003). The term "insight" refers to patient's ability to recognize that his/her symptoms are associated with a mental illness and as such require an appropriate treatment.…”