Determinants of adherence to treatment in first-episode psychosis: a comprehensive review
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
;
37(2): 168-176, 12/05/2015. tab
Article
in English
| LILACS
| ID: lil-748972
ABSTRACT
Objective:
To conduct a comprehensive review of current evidence on factors for nonadherence to treatment in individuals with first-episode psychosis (FEP).Methods:
MEDLINE, LILACS, PsycINFO, and SciELO databases were searched with the keywords first episode psychosis, factor, adherence, nonadherence, engagement, disengagement, compliance, and intervention. References of selected studies were consulted for relevant articles.Results:
A total of 157 articles were screened, of which 33 articles were retained for full review. The factors related to nonadherence were a) patient-related (e.g., lower education level, persistent substance use, forensic history, unemployment, history of physical abuse); b) environment-related (e.g., no family involved in treatment, social adjustment difficulties); c) medication-related (e.g., rapid remission of negative symptoms when starting treatment, therapeutic alliance); and d) illness-related (e.g., more positive symptoms, more relapses). Treatment factors that improve adherence include a good therapeutic alliance and a voluntary first admission when hospitalization occurs.Conclusion:
The results of this review suggest that nonadherence to treatment in FEP is multifactorial. Many of these factors are modifiable and can be specifically targeted in early intervention programs. Very few studies have assessed strategies to raise adherence in FEP. .
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Psychotic Disorders
/
Antipsychotic Agents
/
Treatment Refusal
Type of study:
Etiology study
/
Prognostic study
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
Language:
English
Journal:
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
Journal subject:
Psychiatry
Year:
2015
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Universidade Federal de São Paulo/BR
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