Medication adherence in schizophrenia: The role of insight, therapeutic alliance and perceived trauma associated with psychiatric care.
Psychiatry Research. 2017-11-01; 257: 315-321
DOI: 10.1016/j.psychres.2017.07.063
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1. Psychiatry Res. 2017 Nov;257:315-321. doi: 10.1016/j.psychres.2017.07.063.
Epub 2017 Jul 31.
Medication adherence in schizophrenia: The role of insight, therapeutic alliance
and perceived trauma associated with psychiatric care.
Tessier A(1), Boyer L(2), Husky M(3), Baylé F(4), Llorca PM(5), Misdrahi D(6).
Author information:
(1)INCIA-CNRS UMR 5287, Université Bordeaux, 33076 Bordeaux, France; Pole de
Psychiatrie Adulte et Universitaire, C.H. Charles Perrens, 33076 Bordeaux cedex,
France. Electronic address: .
(2)Université de Aix-Marseille, EA 3279-Santé Publique, Maladies Chroniques et
Qualité de Vie-Unité de Recherche, France. Electronic address:
.
(3)Université de Bordeaux, Laboratoire de Psychologie EA4149, Institut
Universitaire de France, 33000 Bordeaux, France. Electronic address:
.
(4)Université Paris V, Service Hospitalo-Universitaire de Santé Mentale et
Thérapeutique, Hôpital Sainte-Anne, 75014 Paris, France. Electronic address:
.
(5)CHU de Clermont-Ferrand, Service de Psychiatrie, Place Henri Dunant, 63000
Clermont-Ferrand, France. Electronic address: .
(6)INCIA-CNRS UMR 5287, Université Bordeaux, 33076 Bordeaux, France; Pole de
Psychiatrie Adulte et Universitaire, C.H. Charles Perrens, 33076 Bordeaux cedex,
France. Electronic address: .
Medication non adherence in schizophrenia is a major cause of relapse and
hospitalization and remains for clinicians an important challenge. This study
investigates the associations between insight, therapeutic alliance, perceived
trauma related to psychiatric treatment and medication adherence in patients
with schizophrenia. In this multicenter study, 72 patients were assessed
regarding symptomatology, self-reported adherence with medication, insight,
medication side-effects, therapeutic alliance and perceived trauma related to
psychiatric treatment. Structural Equation Modeling (SEM) was used to test
predicted paths among these variables. The data fit a model in which medication
adherence was directly predicted by insight, therapeutic alliance and perceived
trauma related to psychiatric treatment. Perceived trauma moderates the role of
insight on medication adherence. The final model showed good fit, based on four
reliable indices. Greater adherence was correlated with higher insight, higher
therapeutic alliance and lower perceived trauma. These three variables appear to
be important determinants of patient’s medication adherence. Medication
adherence could be enhanced by reducing perceived trauma and by increasing
insight. The need for mental health providers to acknowledge patients’
potentially traumatic experience with psychiatric treatment and the need to
encourage greater involvement in care are discussed.
Copyright © 2017 Elsevier B.V. All rights reserved.
DOI: 10.1016/j.psychres.2017.07.063
PMID: 28800510 [Indexed for MEDLINE]