Predictors of medication discontinuation by patients with first-episode schizophrenia and schizoaffective disorder |
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Authors: | Robinson Delbert G Woerner Margaret G Alvir Jose Ma J Bilder Robert M Hinrichsen Gregory A Lieberman Jeffrey A |
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Institution: | Department of Psychiatry Research, Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, New York 11004, USA. robinson@lij.edu |
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Abstract: | BACKGROUND: Enhancing medication adherence early in the course of schizophrenia and schizoaffective disorder may substantially improve long-term course. Although extensively studied in multi-episode patients, little data exist on medication adherence by first-episode patients. METHOD: Medication adherence was assessed during the first year of treatment and following recovery from the first relapse in patients treated by a standardized medication algorithm. RESULTS: During the first year of treatment, patients with poorer premorbid cognitive functioning were more likely to stop antipsychotics (t=-2.54, df=75, p=0.01). Parkinsonian side effects increased the likelihood (hazard ratio=41.22; 95% CI=2.30, 737.89; p=0.01), and better executive function decreased the likelihood (hazard ratio=0.40; 95% CI=0.18, 0.88; p=0.02) that patients discontinued maintenance medication after a first relapse. CONCLUSION: Interventions to ameliorate cognitive deficits and Parkinsonian side effects may enhance treatment adherence. |
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