Risk factors for medication non-adherence in patients with first episode schizophrenia and related disorders; a prospective five year follow-up.

INTRODUCTION

The goal of this study is to assess, prospectively, the relative contribution of baseline variables to long-term medication adherence in patients with a first episode of schizophrenia.

METHODS

Consecutively admitted patients suffering from a first episode of schizophrenia or related disorders were investigated. Subjective experience, attitudes towards treatment, insight, interaction with members of staff, involuntary admission, substance abuse, and severity of psychopathology were independently assessed at first admission and related to medication adherence during five year follow up.

RESULTS

Standard multiple regression analysis revealed that hostility and uncooperativeness (p=0.007) and involuntary admission (p=0.02) were associated with the level of adherence during 5 year follow-up after admission.

DISCUSSION: In first episode schizophrenia and related disorders, the initial interaction with staff and involuntary admission partly predicts long-term adherence to antipsychotic medication. Ameliorating these initial interactions might have long-term consequences on medication adherence. Involuntary admitted patients need intensive outpatient care.