Non-adherence to antipsychotic medication, relapse and rehospitalisation in recent-onset schizophrenia

TLDR

The study aimed to compare relapse, hospitalization, persistent psychotic symptoms, and coercive treatment use between adherent and non‑adherent patients with recent‑onset schizophrenia. Fifty clinically stable patients with less than two years of psychotic symptoms were followed for 24 months, with good adherence defined as fewer than one month off medication. Non‑adherence was linked to a 10.27‑fold higher risk of psychotic relapse and a 4.00‑fold higher risk of hospitalization, and depot antipsychotics increased relapse risk (OR = 6.44). Interventions to improve adherence are required; the trial is registered under NCT00184509.

Abstract

The aims of this study were to describe outcome with respect to persistent psychotic symptoms, relapse of positive symptoms, hospital admissions, and application of treatment by coercion among patients with recent onset schizophrenia being adherent and non-adherent to anti-psychotic medication.The study included 50 patients with recent onset schizophrenia, schizoaffective or schizophreniform disorders. The patients were clinically stable at study entry and had less than 2 years duration of psychotic symptoms. Good adherence to antipsychotic medication was defined as less than one month without medication. Outcomes for poor and good adherence were compared over a 24-month follow-up period.The Odds Ratio (OR) of having a psychotic relapse was 10.27 and the OR of being admitted to hospital was 4.00 among non-adherent patients. Use of depot-antipsychotics were associated with relapses (OR = 6.44).Non-adherence was associated with relapse, hospital admission and having persistent psychotic symptoms. Interventions to increase adherence are needed.Current Controlled Trials NCT00184509. Key words: Adherence, schizophrenia, antipsychotic medication, admittances, relapse.