Abstract
BackgroundThis study aimed to examine factors associated with treatment adherence in first-episode psychosis (FEP) patients followed up over 8 years, especially involuntary first admission and stopping cannabis use.MethodsThis prospective, longitudinal study of FEP patients collected data on symptoms, adherence, functioning, and substance use. Adherence to treatment was the main outcome variable and was categorized as ‘good’ or ‘bad’. Cannabis use during follow-up was stratified as continued use, stopped use, and never used. Bivariate and logistic regression models identified factors significantly associated with adherence and changes in adherence over the 8-year follow-up period.ResultsOf the 98 FEP patients analyzed at baseline, 57.1% had involuntary first admission, 74.4% bad adherence, and 52% cannabis use. Good adherence at baseline was associated with Global Assessment of Functioning score (p = 0.019), Hamilton Depression Rating Scale score (p = 0.017) and voluntary admission (p < 0.001). Adherence patterns over 8 years included: 43.4% patients always bad, 26.1% always good, 25% improved from bad to good. Among the improved adherence group, 95.7% had involuntary first admission and 38.9% stopped cannabis use. In the subgroup of patients with bad adherence at baseline, involuntary first admission and quitting cannabis use during follow up were associated with improved adherence.ConclusionsThe long-term association between treatment adherence and type of first admission and cannabis use in FEP patients suggest targets for intervention to improve clinical outcomes.
Highlights
This study aimed to examine factors associated with treatment adherence in first-episode psychosis (FEP) patients followed up over 8 years, especially involuntary first admission and stopping cannabis use
Our results suggest that cannabis use and its withdrawal may be a mediator of adherence in FEP patients
This study confirms there is a high rate of cannabis use among patients hospitalized with first-episode psychosis
Summary
This study aimed to examine factors associated with treatment adherence in first-episode psychosis (FEP) patients followed up over 8 years, especially involuntary first admission and stopping cannabis use. First-episode psychosis (FEP) patients often demonstrate denial of illness, refusal to be admitted into a psychiatric unit, and poor medication adherence. Outcome differences between patients admitted voluntarily and involuntarily and the factors associated with these outcomes have not been well studied. In one study of FEP patients, involuntary admission was an independent predictor of medication adherence over 5 years of follow-up [4]. In another study, treatment adherence, psychopathology and functioning at the 2-year follow-up did not differ between FEP patients admitted voluntarily and involuntarily [3]. Most patients admitted involuntarily eventually agree that forced admission was necessary at the time and that their treatment was beneficial, and these perceptions are associated with better insight [13,14]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
