Relationships among medication adherence, insight, and neurocognition in chronic schizophrenia.

Abstract

In order to improve long-term prognosis in schizophrenia, enhancing medication adherence is essential. The aim of this study was thus to identify the association between medication non-adherence and possible risk factors in a large sample of patients with chronic schizophrenia. One hundred and four patients with schizophrenia with a disease duration of over 10 years were enrolled in this cross-sectional study. The subjects were assessed with the Scale to Assess Unawareness of Mental Disease-Korean version, the Korean version of the Medication Adherence Rating Scale, a neurocognition battery designed for this study, and the Positive and Negative Symptoms Scale. An anova and multiple regression models were conducted to identify the correlations among variables and the factors that contribute to medication adherence. The adherence score measured on the Korean version of the Medication Adherence Rating Scale was 7.60 ± 2.12; 88 (84.62%) patients were categorized as well-adherent and 16 (15.38%) as poorly adherent to their medication. Patients with good insight were more likely to maintain their medication (P = 0.0005), and better executive function was associated with increased medication adherence (P = 0.0008). Furthermore, fewer depressive symptoms were associated with good medication adherence (P = 0.0304). This study is the first in the Republic of Korea to identify the relationship between medication adherence, insight, and neurocognition in a large sample of patients with chronic schizophrenia. These results could be used to establish a strategy for improving the prognosis of chronic schizophrenia.