A preliminary communication of an insight scale in the assessment of lithium non-adherence among Chinese patients in Hong Kong

Background: Studies on the relation between insight and medication adherenc e are limited in Chinese populations. Method: Eighty Chinese outpatients wi th mood disorder and on Lithium for at least one year were asked to complet e an Ii-item insight scale. Lithium adherence was determined by: (a) subjec tive report; (b) doctor's clinical impression; or (c) serum Lithium level. Results: The overall insight score (median = 9, range 1-11) exhibited no si gnificant difference between adherent (N = 58, 72.5%) and non-adherent (N = 22, 27.5%) patients. A two-factor model emerged on factor analysis. Lithiu m adherent (median = 7, range 1-7) patients had a significantly higher scor e than non-adherent (median = 6, range 0-7) patients on the 'medical help s eeking' factor (Mann-Whitney U-test Z = 2.00, P < 0.05) but not the 'percep tion of illness' factor. Conclusion: The overall conceptual structure of in sight in Chinese and Western patients appears similar, but further study is required to explore the complexity of Chinese patients' explanatory models of their illness and to enhance the validity of the insight scale. (C) 199 9 Elsevier Science B.V. All rights reserved.