Medication adherence in schizophrenia: The role of insight, therapeutic alliance and perceived trauma associated with psychiatric care.
Identifieur interne : 000A73 ( Main/Corpus ); précédent : 000A72; suivant : 000A74Medication adherence in schizophrenia: The role of insight, therapeutic alliance and perceived trauma associated with psychiatric care.
Auteurs : Arnaud Tessier ; Laurent Boyer ; Mathilde Husky ; Franck Baylé ; Pierre-Michel Llorca ; David MisdrahiSource :
- Psychiatry research [ 1872-7123 ] ; 2017.
English descriptors
- KwdEn :
- Adult (MeSH), Antipsychotic Agents (administration & dosage), Awareness (physiology), Female (MeSH), Humans (MeSH), Male (MeSH), Medication Adherence (psychology), Middle Aged (MeSH), Professional-Patient Relations (MeSH), Psychological Trauma (etiology), Psychological Trauma (psychology), Schizophrenia (drug therapy), Schizophrenia (physiopathology).
- MESH :
- chemical , administration & dosage : Antipsychotic Agents.
- drug therapy : Schizophrenia.
- etiology : Psychological Trauma.
- physiology : Awareness.
- physiopathology : Schizophrenia.
- psychology : Medication Adherence, Psychological Trauma.
- Adult, Female, Humans, Male, Middle Aged, Professional-Patient Relations.
Abstract
Medication non adherence in schizophrenia is a major cause of relapse and hospitalization and remains for clinicians an important challenge. This study investigates the associations between insight, therapeutic alliance, perceived trauma related to psychiatric treatment and medication adherence in patients with schizophrenia. In this multicenter study, 72 patients were assessed regarding symptomatology, self-reported adherence with medication, insight, medication side-effects, therapeutic alliance and perceived trauma related to psychiatric treatment. Structural Equation Modeling (SEM) was used to test predicted paths among these variables. The data fit a model in which medication adherence was directly predicted by insight, therapeutic alliance and perceived trauma related to psychiatric treatment. Perceived trauma moderates the role of insight on medication adherence. The final model showed good fit, based on four reliable indices. Greater adherence was correlated with higher insight, higher therapeutic alliance and lower perceived trauma. These three variables appear to be important determinants of patient's medication adherence. Medication adherence could be enhanced by reducing perceived trauma and by increasing insight. The need for mental health providers to acknowledge patients' potentially traumatic experience with psychiatric treatment and the need to encourage greater involvement in care are discussed.
DOI: 10.1016/j.psychres.2017.07.063
PubMed: 28800510
Links to Exploration step
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Electronic address: laurent.boyer@ap-hm.fr.</nlm:affiliation></affiliation></author><author><name sortKey="Husky, Mathilde" sort="Husky, Mathilde" uniqKey="Husky M" first="Mathilde" last="Husky">Mathilde Husky</name><affiliation><nlm:affiliation>Université de Bordeaux, Laboratoire de Psychologie EA4149, Institut Universitaire de France, 33000 Bordeaux, France. Electronic address: mathilde.husky@u-bordeaux.fr.</nlm:affiliation></affiliation></author><author><name sortKey="Bayle, Franck" sort="Bayle, Franck" uniqKey="Bayle F" first="Franck" last="Baylé">Franck Baylé</name><affiliation><nlm:affiliation>Université Paris V, Service Hospitalo-Universitaire de Santé Mentale et Thérapeutique, Hôpital Sainte-Anne, 75014 Paris, France. 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Charles Perrens, 33076 Bordeaux cedex, France. Electronic address: atessier@ch-perrens.fr.</nlm:affiliation></affiliation></author><author><name sortKey="Boyer, Laurent" sort="Boyer, Laurent" uniqKey="Boyer L" first="Laurent" last="Boyer">Laurent Boyer</name><affiliation><nlm:affiliation>Université de Aix-Marseille, EA 3279-Santé Publique, Maladies Chroniques et Qualité de Vie-Unité de Recherche, France. Electronic address: laurent.boyer@ap-hm.fr.</nlm:affiliation></affiliation></author><author><name sortKey="Husky, Mathilde" sort="Husky, Mathilde" uniqKey="Husky M" first="Mathilde" last="Husky">Mathilde Husky</name><affiliation><nlm:affiliation>Université de Bordeaux, Laboratoire de Psychologie EA4149, Institut Universitaire de France, 33000 Bordeaux, France. Electronic address: mathilde.husky@u-bordeaux.fr.</nlm:affiliation></affiliation></author><author><name sortKey="Bayle, Franck" sort="Bayle, Franck" uniqKey="Bayle F" first="Franck" last="Baylé">Franck Baylé</name><affiliation><nlm:affiliation>Université Paris V, Service Hospitalo-Universitaire de Santé Mentale et Thérapeutique, Hôpital Sainte-Anne, 75014 Paris, France. Electronic address: f.bayle@ch-sainte-anne.fr.</nlm:affiliation></affiliation></author><author><name sortKey="Llorca, Pierre Michel" sort="Llorca, Pierre Michel" uniqKey="Llorca P" first="Pierre-Michel" last="Llorca">Pierre-Michel Llorca</name><affiliation><nlm:affiliation>CHU de Clermont-Ferrand, Service de Psychiatrie, Place Henri Dunant, 63000 Clermont-Ferrand, France. Electronic address: pmllorca@chu-clermontferrand.fr.</nlm:affiliation></affiliation></author><author><name sortKey="Misdrahi, David" sort="Misdrahi, David" uniqKey="Misdrahi D" first="David" last="Misdrahi">David Misdrahi</name><affiliation><nlm:affiliation>INCIA-CNRS UMR 5287, Université Bordeaux, 33076 Bordeaux, France; Pole de Psychiatrie Adulte et Universitaire, C.H. Charles Perrens, 33076 Bordeaux cedex, France. Electronic address: david.misdrahi@u-bordeaux.fr.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Psychiatry research</title><idno type="eISSN">1872-7123</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Antipsychotic Agents (administration & dosage)</term><term>Awareness (physiology)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Medication Adherence (psychology)</term><term>Middle Aged (MeSH)</term><term>Professional-Patient Relations (MeSH)</term><term>Psychological Trauma (etiology)</term><term>Psychological Trauma (psychology)</term><term>Schizophrenia (drug therapy)</term><term>Schizophrenia (physiopathology)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antipsychotic Agents</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Schizophrenia</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Psychological Trauma</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Awareness</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Schizophrenia</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Medication Adherence</term><term>Psychological Trauma</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Professional-Patient Relations</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Medication non adherence in schizophrenia is a major cause of relapse and hospitalization and remains for clinicians an important challenge. This study investigates the associations between insight, therapeutic alliance, perceived trauma related to psychiatric treatment and medication adherence in patients with schizophrenia. In this multicenter study, 72 patients were assessed regarding symptomatology, self-reported adherence with medication, insight, medication side-effects, therapeutic alliance and perceived trauma related to psychiatric treatment. Structural Equation Modeling (SEM) was used to test predicted paths among these variables. The data fit a model in which medication adherence was directly predicted by insight, therapeutic alliance and perceived trauma related to psychiatric treatment. Perceived trauma moderates the role of insight on medication adherence. The final model showed good fit, based on four reliable indices. Greater adherence was correlated with higher insight, higher therapeutic alliance and lower perceived trauma. These three variables appear to be important determinants of patient's medication adherence. Medication adherence could be enhanced by reducing perceived trauma and by increasing insight. The need for mental health providers to acknowledge patients' potentially traumatic experience with psychiatric treatment and the need to encourage greater involvement in care are discussed.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">28800510</PMID><DateCompleted><Year>2018</Year><Month>05</Month><Day>14</Day></DateCompleted><DateRevised><Year>2018</Year><Month>12</Month><Day>02</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1872-7123</ISSN><JournalIssue CitedMedium="Internet"><Volume>257</Volume><PubDate><Year>2017</Year><Month>11</Month></PubDate></JournalIssue><Title>Psychiatry research</Title><ISOAbbreviation>Psychiatry Res</ISOAbbreviation></Journal><ArticleTitle>Medication adherence in schizophrenia: The role of insight, therapeutic alliance and perceived trauma associated with psychiatric care.</ArticleTitle><Pagination><MedlinePgn>315-321</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0165-1781(17)30226-3</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.psychres.2017.07.063</ELocationID><Abstract><AbstractText>Medication non adherence in schizophrenia is a major cause of relapse and hospitalization and remains for clinicians an important challenge. This study investigates the associations between insight, therapeutic alliance, perceived trauma related to psychiatric treatment and medication adherence in patients with schizophrenia. In this multicenter study, 72 patients were assessed regarding symptomatology, self-reported adherence with medication, insight, medication side-effects, therapeutic alliance and perceived trauma related to psychiatric treatment. Structural Equation Modeling (SEM) was used to test predicted paths among these variables. The data fit a model in which medication adherence was directly predicted by insight, therapeutic alliance and perceived trauma related to psychiatric treatment. Perceived trauma moderates the role of insight on medication adherence. The final model showed good fit, based on four reliable indices. Greater adherence was correlated with higher insight, higher therapeutic alliance and lower perceived trauma. These three variables appear to be important determinants of patient's medication adherence. Medication adherence could be enhanced by reducing perceived trauma and by increasing insight. The need for mental health providers to acknowledge patients' potentially traumatic experience with psychiatric treatment and the need to encourage greater involvement in care are discussed.</AbstractText><CopyrightInformation>Copyright © 2017 Elsevier B.V. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Tessier</LastName><ForeName>Arnaud</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>INCIA-CNRS UMR 5287, Université Bordeaux, 33076 Bordeaux, France; Pole de Psychiatrie Adulte et Universitaire, C.H. Charles Perrens, 33076 Bordeaux cedex, France. Electronic address: atessier@ch-perrens.fr.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Boyer</LastName><ForeName>Laurent</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Université de Aix-Marseille, EA 3279-Santé Publique, Maladies Chroniques et Qualité de Vie-Unité de Recherche, France. Electronic address: laurent.boyer@ap-hm.fr.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Husky</LastName><ForeName>Mathilde</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Université de Bordeaux, Laboratoire de Psychologie EA4149, Institut Universitaire de France, 33000 Bordeaux, France. Electronic address: mathilde.husky@u-bordeaux.fr.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Baylé</LastName><ForeName>Franck</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Université Paris V, Service Hospitalo-Universitaire de Santé Mentale et Thérapeutique, Hôpital Sainte-Anne, 75014 Paris, France. Electronic address: f.bayle@ch-sainte-anne.fr.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Llorca</LastName><ForeName>Pierre-Michel</ForeName><Initials>PM</Initials><AffiliationInfo><Affiliation>CHU de Clermont-Ferrand, Service de Psychiatrie, Place Henri Dunant, 63000 Clermont-Ferrand, France. Electronic address: pmllorca@chu-clermontferrand.fr.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Misdrahi</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>INCIA-CNRS UMR 5287, Université Bordeaux, 33076 Bordeaux, France; Pole de Psychiatrie Adulte et Universitaire, C.H. Charles Perrens, 33076 Bordeaux cedex, France. Electronic address: david.misdrahi@u-bordeaux.fr.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>07</Month><Day>31</Day></ArticleDate></Article><MedlineJournalInfo><Country>Ireland</Country><MedlineTA>Psychiatry Res</MedlineTA><NlmUniqueID>7911385</NlmUniqueID><ISSNLinking>0165-1781</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D014150">Antipsychotic Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014150" MajorTopicYN="N">Antipsychotic Agents</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001364" MajorTopicYN="N">Awareness</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="Y">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055118" MajorTopicYN="N">Medication Adherence</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011369" MajorTopicYN="Y">Professional-Patient Relations</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000067073" MajorTopicYN="N">Psychological Trauma</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012559" MajorTopicYN="N">Schizophrenia</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Coercion</Keyword><Keyword MajorTopicYN="Y">Insight</Keyword><Keyword MajorTopicYN="Y">Medication adherence</Keyword><Keyword MajorTopicYN="Y">Schizophrenia</Keyword><Keyword MajorTopicYN="Y">Therapeutic alliance</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2017</Year><Month>02</Month><Day>08</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2017</Year><Month>05</Month><Day>30</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2017</Year><Month>07</Month><Day>29</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>8</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2018</Year><Month>5</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>8</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28800510</ArticleId><ArticleId IdType="pii">S0165-1781(17)30226-3</ArticleId><ArticleId IdType="doi">10.1016/j.psychres.2017.07.063</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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