Insight and Hostility as Predictors and Correlates of Nonadherence in the European First Episode Schizophrenia Trial
Abstrakt
The association of hostility and insight ratings (PANSS items) with medication adherence measured by Hayward scale was investigated in 443 first episode patients diagnosed with schizophrenia, schizoaffective disorder or schizophreniform disorder. The patients took part in the EUFEST study.
Prospectively, high hostility score at baseline significantly predicted nonadherence at 1st month of treatment and low insight at baseline significantly predicted nonadherence at months 1, 6 and 12. The increase of hostility and decrease in insight (over 4 points in PANSS ratings) resulted in an additive OR (95% cofidence limits) for both variables of 73, 5 at month 1, OR 276,1 at month 3 and OR 77,6 at month 6.
Lack of insight and its decrease appear to have greater and more stable predictive association with adherence than hostility. The effects of both variables on adherence do not interact.