Observational studyBMC psychiatry2015
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.
Observational study in BMC psychiatry, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 3 of them syntheses that pooled it.
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Who cites it
49 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Clinical and Sociodemographic Correlates of Poor Medication Adherence in People With Bipolar Disorder: A Systematic Review and Meta-Analysis.Bipolar disorders · 2026Pooled it
- Differential power of placebo across major psychiatric disorders: a preliminary meta-analysis and machine learning study.Scientific reports · 2021Pooled it
- Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: a systematic review and meta-analysis.Systematic reviews · 2020Pooled it
- The impact of the motherhood role on recovery motivation in women with severe mental illness.Annals of medicine · 2026Article
- A cross-sectional study of the influence of patient experience and psychological contract on medication adherence in depressive patients.Exploratory research in clinical and social pharmacy · 2026Article
- Clinical Trajectories Associated with Pharmacological Treatment Patterns in Female Adolescents with Anorexia Nervosa: A 12-Month Retrospective Study in Italian Real-World Clinical Practice.Journal of clinical medicine · 2026Article
- The impact of symptoms and illness insight on treatment adherence in first-episode psychosis: a one-year follow-up study using therapeutic drug monitoring.BMC psychiatry · 2026Article
- Artificial Intelligence Centrality in Psychotic Delusions and Violence Risk in Forensic Psychiatry: Retrospective Observational Study of Judicial Decisions.Journal of medical Internet research · 2026Observational
- The Relationship Between Early-Stage Maladaptive Schemas and Treatment Adherence in Patients Diagnosed with Bipolar Disorder in Remission.Journal of clinical medicine · 2026Article
- Insight and Its Trajectory: Predicting the Risk of Psychiatric Hospitalizations Among First-Episode Psychosis During the First Year of Coordinated Specialty Care.Schizophrenia bulletin · 2026Article
- Practical Psychosocial Management for Patients With Bipolar Disorder.American journal of psychotherapy · 2025Review
- Assessments of the Factor Structure and Psychometric Properties of the Persian Version of the 30-Item Drug Attitude Inventory in Patients with Schizophrenia.Addiction & health · 2025Article
- Global Assessment of Medication Adherence: Correlational Analyses of a Brief Tool for Evaluating Medication Adherence in Patients with Severe Mental Disorders.Psychiatry and clinical psychopharmacology · 2024Article
- Medication non-adherence and associated factors among peoples with schizophrenia: multicenter cross-sectional study in Northwest Ethiopia.BMC psychiatry · 2024Article
- Evaluation of the Relationship between Disability and Disease Severity, Cognitive Functions, and Insight in Patients with Schizophrenia.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2024Article
- Self-Stigma in Patients with Endogenous Mental Disorders: A Cross-Sectional Comparative Study.Consortium psychiatricum · 2024Article
- Challenges and strategies for improving medication adherence among adolescent psychiatric patients: A qualitative study.Global mental health (Cambridge, England) · 2024Article
- Schizophrenia and medication adherence among the population in Morocco: a cross-sectional study at the University Psychiatric Center of Casablanca.The Pan African medical journal · 2024Article
- Perceptions of nurses working in mental health services regarding the recovery-oriented care approach: Findings from Africa.Nursing open · 2023Article
- Article
Corrections and comments
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Authors and funding
6 authors.
Funding
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Abstract
backgroundMany 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.
methodsWe 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).
resultsMedication 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).
conclusionInsight 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.
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