Association Between Attitude Toward Medication and Neurocognitive Function in Schizophrenia

Abstract

A patient's attitude toward medication is important for medication adherence, which is a key determinant of outcome in schizophrenia. This study examined the association between attitude toward antipsychotic medication and clinical status, particularly neurocognitive function, in patients with schizophrenia. Ninety-two patients meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for schizophrenia participated in this study. The attitudes of the subjects toward medication were evaluated using the Drug Attitude Inventory (DAI). Clinical characteristics, including psychiatric symptoms and side effects of medication were evaluated. Neurocognitive function was measured using the Mini Mental State Examination and a computerized battery consisting of the Digit Span Test, Verbal Learning Test, Continuous Performance Test, Wisconsin Card Sorting Test, Finger Tapping Test, and Trail Making Test, parts A and B. The associations between attitude toward medication and neurocognitive function and clinical characteristics were analyzed. The scores on the DAI were not significantly correlated with the clinical characteristics, such as psychopathology, subjective well-being, or neuroleptic-induced extrapyramidal side effects. Instead, the scores on the DAI were significantly correlated with the learning index and delayed free recall on the Verbal Learning Test, the number of categories completed on the Wisconsin Card Sorting Test, and omission and commission errors on the Continuous Performance Test; the scores were not significantly correlated with measures on the Mini Mental State Examination, Digit Span Test, Finger Tapping Test, or Trail Making Test. Our findings indicate that a patient's attitude toward medication is associated with neurocognitive function. Specifically, verbal learning memory, executive functioning, and sustained attention were associated with attitude toward medication.