PMID- 26239486
OWN - NLM
STAT- MEDLINE
DCOM- 20160219
LR  - 20181202
IS  - 1471-244X (Electronic)
IS  - 1471-244X (Linking)
VI  - 15
DP  - 2015 Aug 5
TI  - Relationship of insight with medication adherence and the impact on outcomes in 
      patients with schizophrenia and bipolar disorder: results from a 1-year European 
      outpatient observational study.
PG  - 189
LID - 10.1186/s12888-015-0560-4 [doi]
LID - 189
AB  - BACKGROUND: Many patients with schizophrenia and bipolar disorder have impaired 
      insight and low medication adherence. The aim of this post hoc analysis was to 
      explore the relationship between insight and medication adherence. METHODS: We 
      included 903 patients with schizophrenia or bipolar disorder who participated in 
      an observational study conducted in Europe on the outcomes of patients treated 
      with two oral formulations of olanzapine over a 1-year period. Evaluations 
      included Clinical Global Impression (CGI), Global Assessment of Functioning 
      (GAF), insight (Scale to Assess Unawareness of Mental Disorder, SUMD) medication 
      adherence (Medication Adherence Rating Scale, MARS), and therapeutic alliance 
      (Working Alliance Inventory, WAI). RESULTS: Medication adherence was higher in 
      bipolar patients (mean MARS score (SD) 6.5 (2.8) versus 5.8 (2.7) in 
      schizophrenia; p < 0.001). Patients with schizophrenia had lower insight (i.e., 
      SUMD item 1, unawareness of mental disorder, mean (SD) of 2.5 (1.3) in 
      schizophrenia versus 1.9 (1.2) in bipolar, p < 0.001). Better insight was 
      associated with higher adherence (Spearman Correlation Coefficient, SCC, ranging 
      from 0.39 to 0.49 for the three SUMD general items, p < 0.0001 in all cases). 
      Higher insight was related to a stronger therapeutic alliance (SCC ranging from 
      0.38 to 0.48, p < 0.0001). A path analysis revealed a positive impact of insight 
      on adherence and alliance and that stronger alliance was related to lower 
      clinical severity (lower CGI score). CONCLUSION: Insight and adherence were found 
      to be closely related. Insight impacts on the therapeutic alliance with mental 
      health professionals. These factors are associated to treatment outcomes.
FAU - Novick, Diego
AU  - Novick D
AD  - Global Health Outcomes Research, Lilly Research Centre, Eli Lilly and Company, 
      Erl Wood Manor, Windlesham, Surrey, GU20 6PH, UK. novick_diego@lilly.com.
FAU - Montgomery, William
AU  - Montgomery W
AD  - Eli Lilly Australia Pty Ltd, West Ryde, Australia. montgomery_bill@lilly.com.
FAU - Treuer, Tamas
AU  - Treuer T
AD  - Eli Lilly and Company, Budapest, Hungary. treuer_tamas@lilly.com.
FAU - Aguado, Jaume
AU  - Aguado J
AD  - Parc Sanitari Sant Joan de Deu, CIBERSAM, Universitat de Barcelona, Barcelona, 
      Spain. jaguado@pssjd.org.
FAU - Kraemer, Susanne
AU  - Kraemer S
AD  - Lilly Deutschland GmbH, Bad Homburg, Germany. kraemer_susanne@lilly.com.
FAU - Haro, Josep Maria
AU  - Haro JM
AD  - Parc Sanitari Sant Joan de Deu, CIBERSAM, Universitat de Barcelona, Barcelona, 
      Spain. 27652jha@comb.cat.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20150805
PL  - England
TA  - BMC Psychiatry
JT  - BMC psychiatry
JID - 100968559
RN  - 12794-10-4 (Benzodiazepines)
RN  - N7U69T4SZR (Olanzapine)
SB  - IM
MH  - Adult
MH  - Benzodiazepines/therapeutic use
MH  - Bipolar Disorder/*drug therapy/*psychology
MH  - *Comprehension
MH  - Europe
MH  - Female
MH  - Humans
MH  - Male
MH  - Medication Adherence/*psychology
MH  - Middle Aged
MH  - Olanzapine
MH  - Outpatients/psychology
MH  - Schizophrenia/*drug therapy
MH  - *Schizophrenic Psychology
MH  - Treatment Outcome
PMC - PMC4524170
EDAT- 2015/08/05 06:00
MHDA- 2016/02/20 06:00
PMCR- 2015/08/05
CRDT- 2015/08/05 06:00
PHST- 2014/12/21 00:00 [received]
PHST- 2015/07/14 00:00 [accepted]
PHST- 2015/08/05 06:00 [entrez]
PHST- 2015/08/05 06:00 [pubmed]
PHST- 2016/02/20 06:00 [medline]
PHST- 2015/08/05 00:00 [pmc-release]
AID - 10.1186/s12888-015-0560-4 [pii]
AID - 560 [pii]
AID - 10.1186/s12888-015-0560-4 [doi]
PST - epublish
SO  - BMC Psychiatry. 2015 Aug 5;15:189. doi: 10.1186/s12888-015-0560-4.