Nonadherence to Medication Four Years After a First Episode of Psychosis and Associated Risk Factors
Abstract
OBJECTIVES: This study examined concurrent associations and predictors at first indication of nonadherence to antipsychotic medication four years after a first episode of psychosis. METHODS: A prospective cohort of 171 patients in urban Ireland with a first episode of psychosis was followed up four years after inception (follow-up primary analysis, N=84; secondary analysis, N=104). RESULTS: At the four-year follow-up 76% were adherent and 24% were not. Nonadherence was concurrently associated with substance misuse (p<.01), increased symptomatology (p<.01), less insight (p=.01), lower global functioning (p<.01), and negative attitudes toward medication (p<.01). Compared with other patients, those who were nonadherent had more readmissions (p=.01). Predictors of future nonadherence were substance misuse (p=.02) and duration of untreated psychosis (p=.04). CONCLUSIONS: This prospective investigation confirms previous cross-sectional studies. The association between longer duration of untreated psychosis and nonadherence warrants further research because it could be interpreted as further evidence of the importance of early intervention.
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Both psychostimulant and psycho-depressant substances misuse were associated with psychotropic medication non-adherence in eight studies.
“In eight studies, both psychostimulant and psycho-depressant substances misuse were associated with psychotropic medication non-adherence [23, 27, 29, 37, 42, 43, 58, 65].”
From Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: A systematic review and meta-analysis (2020) · cites this paper as [27]
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Medication Non‐Adherence in First Episode Psychosis: A Systematic Review
Hunt, J., & Georgiades, A. (2026) · Early Intervention in Psychiatry · doi:10.1111/eip.70234
- Authors
- Hill, M., Crumlish, N., Whitty, P., Clarke, M., Browne, S., Kamali, M., Kinsella, A., Waddington, J. L., Larkin, C., & O'Callaghan, E.
- Venue
- Psychiatric Services
- Published
- 2010-02
- Volume
- 61
- Issue
- 2
- Pages
- 189-192
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W2118063631
- Cited by
- 48
- References
- 15
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 1 · 2023: 3 · 2022: 1 · 2020: 3 · 2019: 4 · 2018: 2 · 2017: 3 · 2016: 5 · 2015: 9 · 2014: 2 · 2013: 6 · 2012: 2
- FWCI
- 2.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- HRB National Drugs Library (Health Research Board) (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 › Social Psychology › Mental Health Treatment and Access
- Keywords
- medication non-adherence, antipsychotic drugs, first-episode psychosis, substance abuse, insight, global functioning, attitudes toward medication, hospital readmission, duration of untreated psychosis, early intervention, risk factors
- MeSH terms
- Adult, Female, Follow-Up Studies, Humans, Ireland, Male, Middle Aged, Patient Readmission, Prospective Studies, Psychiatric Status Rating Scales, Psychotic Disorders, Social Adjustment, Antipsychotic Agents, Urban Population, Cohort Studies, Comorbidity, Outcome Assessment, Health Care, Substance-Related Disorders, Medication Adherence, Young Adult
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