Risk Factors for Medication Non-Adherence in Patients with First Episode Schizophrenia and Related Disorders; A Prospective Five Year Follow-Up
Abstract
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.
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There was no association between legal status or perceived coercion and adherence to treatment plans.
“By contrast, two studies found no association between legal status or perceived coercion and adherence to treatment plans (38,39), or medication as measured by blood levels over two years (22).”
From The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review (2025) · cites this paper as [38]
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“As for the four studies that were excluded from the quantitative analysis, one (de Haan et al. 2007) also reported a significant positive association between 1696 E. Foglia et al. C annabis use and adherence to antipsychotic m edication 1697 Table 2 (cont.)”
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“…have identified prictors for treatment discontinuation or nonadherence in first-episode patients (Verdoux et al. 2000, Kampman et al. 2002, Robinson et al. 2002, Mutsatsa et al. 2003, Perkins et al. 2006, De Haan et al. 2007, Perkins et al. 2008, Rabinovitch et al. 2009, Miller et al. 2009).”
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“Indeed, coercive measures may have severe, enduring negative effects on the people targeted, such as increased use of future coercive measures [3, 4], worse quality of life [5], reduced treatment adherence [6] and lower satisfaction with care [7].”
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“…symptoms at onset (Gearon and Bellack, 2000; Dawe et al., 2011), lower compliance and worse treatment response, thus more inappropriate use of mental health services, (Lambert et al., 2005; de Haan et al., 2007; Schimmelmann et al., 2011) with higher mental health costs (Bartels et al., 1993).”
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- Authors
- de Haan, L., van Amelsvoort, T., Dingemans, P., & Linszen, D.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Venue
- Pharmacopsychiatry
- Publisher
- Georg Thieme Verlag KG
- Published
- 2007-11
- Volume
- 40
- Issue
- 6
- Pages
- 264-268
- ISSN
- 0176-3679 (ISSN-L)
- 1439-0795
- OpenAlex
- W1980143549
- Cited by
- 48
- References
- 0
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 4 · 2022: 3 · 2021: 4 · 2020: 3 · 2019: 2 · 2018: 3 · 2017: 5 · 2016: 2 · 2015: 3 · 2014: 1 · 2013: 5 · 2012: 2
- FWCI
- 2.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pharmacopsychiatry (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Keywords
- medication non-adherence, antipsychotic drugs, first-episode schizophrenia, risk factors, hostility, involuntary admission, staff-patient interaction, treatment attitudes, insight, substance abuse, psychopathology severity, long-term follow-up
- MeSH terms
- Adult, Attitude, Female, Follow-Up Studies, Hospitalization, Humans, Male, Prospective Studies, Psychiatric Status Rating Scales, Regression Analysis, Risk Factors, Schizophrenia, Schizophrenic Psychology, Sex Factors, Antipsychotic Agents, Treatment Refusal, Treatment Outcome
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