P03-55 - The correlates of subjective admission experience of patients with schizophrenia in Hong Kong

Abstract

ObjectiveAdmission experience has been shown to be related to insight and treatment adherence. We evaluated the clinical correlates of the Chinese Admission Experience Survey (C-AES).MethodsA four-week longitudinal correlation study was carried out to investigate the relationship between admission experience and clinical variables. The C-AES was administered to 40 patients with schizophrenia within 48 hours of admission as a baseline, followed by subsequent interviews at two weeks and four weeks post-admission. Degree of insight into disease, attitude towards prescription, medication side effects and psychiatric symptomatology were assessed using established instruments, namely the Scale to Assess Unawareness of Mental Disorder (SUMD), the Drug Attitude Inventory (DAI), the Extrapyramidal Symptom Rating Scale (ESRS), the Scale for the Assessment of Negative Symptoms (SANS) and Scale for the Assessment of Positive Symptoms (SAPS). Regression by Generalised Estimating Equations (GEE) was used to evaluate the relationship between the clinical variables.ResultsAn improvement in insight was associated with a reduction in perceived coercion (B = 0.261, p < 0.01) during the four-week treatment. An increase in atypical antipsychotic dosage in milligram of chlorpromazine equivalents predicted insight improvement (B = -0.001, p < 0.01). There was an associated improvement in attitude towards medication (B = -0.027, p < 0.01). These observations were independent on schizophrenic symptoms or extrapyrimidal side effects.ConclusionsImprovement in insight is associated with a reduction in perceived coercion and a more positive attitude towards prescription, and is predicted by a higher dosage of atypical antipsychotic.