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A prospective evaluation of adherence to medication in first episode schizophrenia

Published online by Cambridge University Press:  16 April 2020

M. Kamali ,
B.D. Kelly ,
M. Clarke ,
S. Browne ,
M. Gervin ,
A. Kinsella ,
A. Lane ,
C. Larkin  and
E. O'Callaghan
M. Kamali
Affiliation:
Stanley Research Unit, Department of Adult Psychiatry, Hospitaller Order of St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
B.D. Kelly
Affiliation:
Stanley Research Unit, Department of Adult Psychiatry, Hospitaller Order of St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland Department of Adult Psychiatry, University College Dublin, Mater Misericordiae University Hospital, 7Dublin, Ireland
M. Clarke
Affiliation:
Stanley Research Unit, Department of Adult Psychiatry, Hospitaller Order of St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
S. Browne
Affiliation:
Stanley Research Unit, Department of Adult Psychiatry, Hospitaller Order of St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland Department of Psychiatry, Waterford Regional Hospital, Dunmore Road, Waterford, Ireland
M. Gervin
Affiliation:
Stanley Research Unit, Department of Adult Psychiatry, Hospitaller Order of St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
A. Kinsella
Affiliation:
School of Mathematics, Dublin Institute of Technology, Dublin, Ireland
A. Lane
Affiliation:
Stanley Research Unit, Department of Adult Psychiatry, Hospitaller Order of St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
C. Larkin
Affiliation:
Stanley Research Unit, Department of Adult Psychiatry, Hospitaller Order of St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
E. O'Callaghan*
Affiliation:
Stanley Research Unit, Department of Adult Psychiatry, Hospitaller Order of St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland St Vincent's University Hospital, Department of Psychiatry, University College Dublin, Ireland DELTA/DETECT Early Intervention in Psychosis Service, Dun Laoghaire, Ireland
*
*Corresponding author. Stanley Research Unit, Department of Adult Psychiatry, Hospitaller Order of St John of God, Cluain Mhuire Service, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland. E-mail address:[email protected] (E. O'Callaghan).
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Abstract

The aim of this study was to identify the features of first episode schizophrenia that predict adherence antipsychotic medication at six-month follow-up. We used validated instruments to assess clinical and socio-demographic variables in all patients with first episode schizophrenia from a defined geographical area admitted to a Dublin psychiatric hospital over a four-year period (N = 100). At six-month follow-up (N = 60) we assessed adherence to medication using the Compliance Interview. One third of patients with schizophrenia were non-adherent with medication within six months of their first episode of illness. High levels of positive symptoms at baseline, lack of insight at baseline, alcohol misuse at baseline and previous drug misuse predict non-adherence. These results indicate that an identifiable subgroup of patients with first episode schizophrenia is at high risk of early non-adherence to medication. While high positive symptom scores pre-date and predict non-adherence in most patients, reduced insight is the best predictor of non-adherence in patients who do not misuse alcohol or other drugs.

Keywords

SchizophreniaTreatmentComplianceMedicationInsight
Type
Original article
Information
European Psychiatry , Volume 21 , Issue 1 , January 2006 , pp. 29 - 33
Copyright
Copyright © Elsevier SAS 2006

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