MEDICATION NONCOMPLIANCE AND SUBSTANCE-ABUSE AMONG PATIENTS WITH SCHIZOPHRENIA

Objective: The study examined the effect of medication noncompliance a nd substance abuse on symptoms of schizophrenia. Methods: Short-term i npatients with a diagnosis of schizophrenia were enrolled in a longitu dinal outcomes study and continued to receive standard care after disc harge. At baseline and six-month follow-up, Brief Psychiatric Rating S cale (BPRS) scores and data on subjects' reported medication complianc e, drug and alcohol abuse, usual living arrangements, and observed sid e effects were obtained. The number of outpatient contacts during the follow-up period was obtained from medical records. Relationships betw een the dependent variables-medication noncompliance and follow-up BPR S scores-and the independent variables were analyzed using logistic an d linear regression models. Results: Medication noncompliance was sign ificantly associated with substance abuse. Subjects who abused substan ces, had no outpatient contact, and were noncompliant with medication had significantly greater symptom severity than other groups, Conclusi ons: Substance abuse is strongly associated with medication noncomplia nce among patients with schizophrenia. The combination of substance ab use, medication noncompliance, and lack of outpatient contact appears to define a particularly high-risk group.