ArticleSchizophrenia bulletin2015
Modeling determinants of medication attitudes and poor adherence in early nonaffective psychosis: implications for intervention.
Article in Schizophrenia bulletin, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Psychosocial Interventions in the Rehabilitation and the Management of Psychosis and Schizophrenia: A Systematic Review on Digitally-Delivered Interventions.Actas espanolas de psiquiatria · 2025Pooled it
- Mobile Phone Ownership and Endorsement of "mHealth" Among People With Psychosis: A Meta-analysis of Cross-sectional Studies.Schizophrenia bulletin · 2016Pooled it
- Investigating the efficacy of an individualized metacognitive therapy program (MCT+) for psychosis: study protocol of a multi-center randomized controlled trial.BMC psychiatry · 2016Trial
- Psychosocial Interventions, Recovery, and Mediating Mechanisms in Schizophrenia-Spectrum Disorders: A Systematic Review and Meta-Analysis of Longitudinal Studies.Brain sciences · 2026Review
- Advances in implementation strategies for treatment adherence in schizophrenia: a narrative review.Frontiers in psychiatry · 2026Review
- Rates and correlates of medication non-adherence behaviors and attitudes in adult patients with early psychosis.Social psychiatry and psychiatric epidemiology · 2024Article
- Role of Clinical Insight at First Month in Predicting Relapse at the Year in First Episode of Psychosis (FEP) Patients.Journal of clinical medicine · 2023Article
- Dynamics between insight and medication adherence in first-episode psychosis: Study of 3-year trajectories.European psychiatry : the journal of the Association of European Psychiatrists · 2022Article
- Characteristics associated with self-reported medication adherence in persons with psychosis referred to psychosocial rehabilitation centers.European archives of psychiatry and clinical neuroscience · 2021Article
- Digital Community Inclusion of Individuals With Serious Mental Illness: A National Survey to Map Digital Technology Use and Community Participation Patterns in the Digital Era.JMIR mental health · 2021Article
- The association between insight and depressive symptoms in schizophrenia: Undirected and Bayesian network analyses.European psychiatry : the journal of the Association of European Psychiatrists · 2020Article
- Article
- Medication adherence in first episode psychosis: the role of pre-onset subthreshold symptoms.Acta psychiatrica Scandinavica · 2019Article
- Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2018Article
- Is It Possible to Predict the Future in First-Episode Psychosis?Frontiers in psychiatry · 2018Review
- Factors affecting medication adherence in children receiving outpatient pharmacotherapy and parental adherence.Journal of child and adolescent psychiatric nursing : official publication of the Association of Child and Adolescent Psychiatric Nurses, Inc · 2015Article
- Neurocognitive and clinical correlates of insight in schizophrenia.Indian journal of psychiatryArticle
Corrections and comments
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Authors and funding
15 authors at 11 institutions in 7 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We 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.
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