Predicting Factors Associated with Drug Compliance in Manic Patients / 신경정신의학

ABSTRACT

OBJECTIVES: Drug compliance is the most important issue in long-term treatment outcome and prognosis of manic patients. Up to date, there has been no study about drug compliance at the point of the first manic episode and subsequent maintenance period. And also there are limited data regarding the rates of noncompliance in patients with bipolar disorder and schizoaffective disorder in Korea. So the author studied about the rate of noncompliance in manic patients and about the clinical predicting factors associated with their drug compliance. METHODS: Compliance of a patient was assessed by patient's report, family member's report, treater's estimation, investigator-administered questionnaire, record of unkept appointment and plasma concentration of mood-stabilizer. Data about patient-related, illness-related and treatment-related factors of compliance were collected by the review of medical records and interview with the patient. RESULTS: Forty patients (56.3%)were noncompliant with their pharmacologic regimen at the point of the first treatment period. Noncompliance was significantly associated with experience of childhood stressful life events(p=.035) presence of psychotic symptoms(p=.020)and treatment with combination of mood-stabilizers(p=.002) CONCLUSION: Patients who experienced serious life event in their childhood, had delusion or hallucination during the manic episode, or received the combination therapy of mood-stabilizer are prone to fail in treatment adherence.