Compliance and schizophrenia: the predictive potential of insight into illness, symptoms, and side effects

Kao, Yu-Cheng; Liu, Yia-Ping

doi:10.1016/j.comppsych.2010.03.007

Cited by 55 publications

(44 citation statements)

References 37 publications

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“…[59] In addition, the relationship between lack of insight and negative symptoms could explain poor treatment adherence among patients with schizophrenia. [6061]…”

Section: Insight and Negative Symptomsmentioning

confidence: 99%

Insight in Schizophrenia: Relationship to Positive, Negative and Neurocognitive Dimensions

Joseph

Narayanaswamy

Venkatasubramanian

2015

Indian Journal of Psychological Medicine

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Impairment of insight is considered as the hallmark of schizophrenia. Substantial proportion of patients with schizophrenia has either poor or absent insight. Insight is a multidimensional and dynamic construct which appears to have intricate links with other symptom dimensions of the psychotic illness. A better appreciation of the association that insight shares with other symptom clusters in psychosis could help us in gaining knowledge about aetiology, prognosis and treatment-related facets of the disorder. This is likely to have critical implications in the understanding and therapeutics of schizophrenia.

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“…[59] In addition, the relationship between lack of insight and negative symptoms could explain poor treatment adherence among patients with schizophrenia. [6061]…”

Section: Insight and Negative Symptomsmentioning

confidence: 99%

Insight in Schizophrenia: Relationship to Positive, Negative and Neurocognitive Dimensions

Joseph

Narayanaswamy

Venkatasubramanian

2015

Indian Journal of Psychological Medicine

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“…Further, the current evidence suggests that the relationship between nonadherence and negative symptoms might be secondary to control of psychotic symptoms. The Kao and Liu (2010) findings that negative symptoms were correlated with lower antipsychotic medication adherence should similarly be reconsidered in light of this potential mediation effect.…”

Section: Discussionmentioning

confidence: 99%

“…The authors hypothesized that the lethargy and lack of motivation associated with avolition and apathy led to the greater nonadherence with clinic visits required for depot antipsychotic medication injections, and speculated that alogia could interfere with treatment and developing greater insight into the need for treatment. The presence of higher levels of negative symptoms on the PANSS (Kay et al, 1987) was shown to be moderately positively correlated with lower oral antipsychotic medication adherence (Kao and Liu, 2010). Baloush-Kleinman et al (2011) found that higher levels of negative symptoms were not directly related to antipsychotic medication adherence, but did indirectly impact medication adherence by influencing attitudes towards medication, which in turn were associated with lower adherence.…”

Section: Introductionmentioning

confidence: 99%

The impact of second-generation antipsychotic adherence on positive and negative symptoms in recent-onset schizophrenia

Subotnik¹,

Ventura²,

Gretchen‐Doorly³

et al. 2014

Schizophrenia Research

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Objective To explore the extent to which initial severity of positive or negative symptoms in patients with recent-onset schizophrenia is related to medication nonadherence during the first outpatient year. Methods The study involved 64 first-episode schizophrenia patients treated with the second-generation oral antipsychotic medication, risperidone, for 12 months. Symptoms were evaluated using the SANS and SAPS completed every 3 months. Pearson correlations between medication adherence and symptoms were examined over each 3-month interval during 12 months of follow-through treatment. Possible causality was inferred from cross-lagged panel analyses. Results As expected, higher levels of adherence with antipsychotic medication were generally associated with lower levels of concurrent reality distortion (mean of SAPS delusions and hallucinations). Greater adherence during the 3-month baseline interval was generally associated with lower levels of avolition-apathy as well as alogia throughout the first outpatient year. However, medication adherence was not significantly associated with decreases in avolition-apathy or alogia over time. Cross-lagged panel analyses based on correlation coefficients are consistent with a causal relationship between initial medication adherence and lower levels of Alogia. A test of mediation confirmed that an indirect path through reality distortion mediated the relationship between medication nonadherence and alogia. Conclusions The associations between greater medication adherence and lower levels of negative symptoms appeared to be accounted for by the relationship of both variables to positive psychotic symptoms. The findings suggest that the impact of second-generation antipsychotic medication on suppression of negative symptoms might be mediated via a reduction in positive symptoms.

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“…In general, the level of patients’ insight has been reported to be related to compliance with treatments and, as a result, with retention in treatment (Husted, 1999; Kao and Liu, 2010; Segarra et al, 2010). Our results are consistent with a previous study by us, which compared the retention in treatment of opioid-dependent subjects with and without Axis-I psychiatric comorbidity.…”

Section: Discussionmentioning

confidence: 99%

Correlations Between Awareness of Illness (Insight) and History of Addiction in Heroin-Addicted Patients

Maremmani¹,

Rovai²,

Rugani³

et al. 2012

Front. Psychiatry

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In a group of 1066 heroin addicts, who were seeking treatment for opioid agonist treatment, we looked for differences in historical, demographic, and clinical characteristics, between patients with different levels of awareness of illness (insight). The results showed that, in the cohort studied, a majority of subjects lacked insight into their heroin-use behavior. Compared with the impaired-insight group, those who possessed insight into their illness showed significantly greater awareness of past social, somatic, and psychopathological impairments, and had a greater number of past treatment-seeking events for heroin addiction. In contrast with other psychiatric illnesses, the presence of awareness appears to be related to the passing of time and to the worsening of the illness. Methodologies to improve the insight of patients should, therefore, be targeted more directly on patients early in their history of heroin dependence, because the risk of lack of insight is greatest during this period.

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Compliance and schizophrenia: the predictive potential of insight into illness, symptoms, and side effects

Cited by 55 publications

References 37 publications

Insight in Schizophrenia: Relationship to Positive, Negative and Neurocognitive Dimensions

Insight in Schizophrenia: Relationship to Positive, Negative and Neurocognitive Dimensions

The impact of second-generation antipsychotic adherence on positive and negative symptoms in recent-onset schizophrenia

Correlations Between Awareness of Illness (Insight) and History of Addiction in Heroin-Addicted Patients

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