Please use this identifier to cite or link to this item: https://hdl.handle.net/20.500.12530/22513
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dc.contributor.authorDrake, Richard J
dc.contributor.authorNordentoft, Merete
dc.contributor.authorHaddock, Gillian
dc.contributor.authorArango, Celso
dc.contributor.authorFleischhacker, W Wolfgang
dc.contributor.authorGlenthøj, Birte
dc.contributor.authorLeboyer, Marion
dc.contributor.authorLeucht, Stefan
dc.contributor.authorLeweke, Markus
dc.contributor.authorMcGuire, Phillip
dc.contributor.authorMeyer-Lindenberg, Andreas
dc.contributor.authorRujescu, Dan
dc.contributor.authorSommer, Iris E
dc.contributor.authorKahn, René S
dc.contributor.authorLewis, Shon W
dc.date.accessioned2019-06-28T13:40:03Z-
dc.date.available2019-06-28T13:40:03Z-
dc.date.issued2015-05
dc.identifier.citationSchizophr Bull.2015 May;(41)3:584-96
dc.identifier.urihttps://hdl.handle.net/20.500.12530/22513-
dc.description.abstractWe aimed to design a multimodal intervention to improve adherence following first episode psychosis, consistent with current evidence. Existing literature identified medication attitudes, insight, and characteristics of support as important determinants of adherence to medication: we examined medication attitudes, self-esteem, and insight in an early psychosis cohort better to understand their relationships. Existing longitudinal data from 309 patients with early Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, nonaffective psychosis (83% first episode) were analyzed to test the hypothesis that medication attitudes, while meaningfully different from "insight," correlated with insight and self-esteem, and change in each influenced the others. Rosenberg Self-Esteem Scale, Birchwood Insight Scale, and Positive and Negative Syndrome Scale insight were assessed at presentation, after 6 weeks and 3 and 18 months. Drug Attitudes Inventory (DAI) and treatment satisfaction were rated from 6 weeks onward. Structural equation models of their relationships were compared. Insight measures' and DAI's predictive validity were compared against relapse, readmission, and remission. Analysis found five latent constructs best fitted the data: medication attitudes, self-esteem, accepting need for treatment, self-rated insight, and objective insight. All were related and each affected the others as it changed, except self-esteem and medication attitudes. Low self-reported insight at presentation predicted readmission. Good 6-week insight (unlike drug attitudes) predicted remission. Literature review and data modeling indicated that a multimodal intervention using motivational interviewing, online psychoeducation, and SMS text medication reminders to enhance adherence without damaging self-concept was feasible and appropriate.
dc.language.isoeng
dc.rightsopenAccess-
dc.subjectadherence
dc.subjectfirst episode
dc.subjectinsight
dc.subjectmHealth
dc.subjectschizophrenia
dc.subjectself-esteem
dc.subjectweb-based
dc.subject.meshAdult
dc.subject.meshAwareness
dc.subject.meshHumans
dc.subject.meshLongitudinal Studies
dc.subject.meshMedication Adherence
dc.subject.meshModels, Statistical
dc.subject.meshPsychotic Disorders
dc.subject.meshHealth Knowledge, Attitudes, Practice
dc.subject.meshSelf Concept
dc.titleModeling determinants of medication attitudes and poor adherence in early nonaffective psychosis: implications for intervention.
dc.typeArtículo
dc.identifier.pubmedID25750247
dc.format.volume41
dc.format.page584-96
dc.identifier.e-issn1745-1701
dc.identifier.journalSchizophrenia bulletin
dc.identifier.doi10.1093/schbul/sbv015
dc.format.number3
dc.identifier.pmcPMC4393703
dc.pubmedtypeJournal Article
dc.pubmedtypeResearch Support, Non-U.S. Gov't
Appears in Collections:Fundaciones e Institutos de Investigación > IIS H. General U. Gregorio Marañón > Artículos

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