Medication adherence in psychosis: predictors and impact on outcome. A 2-year follow-up of first-admitted subjects

Objective: To assess the baseline characteristics predicting poor medicatio n adherence following a first admission for psychosis, and the impact of po or medication adherence on outcome. Method: First-admitted subjects with psychosis (n = 65) were assessed at 6- month intervals over a 2-year follow-up. Medication adherence was assessed using multiple sources of information. Results: Baseline lower occupational status, alcohol misuse and the intensi ty of delusional symptoms and suspiciousness predicted poor medication adhe rence during the 2-year follow-up. Over this period, subjects with poor med ication adherence presented more frequently with an episodic course of illn ess and were more frequently readmitted, especially with regard to involunt ary readmission. Conclusion: In naturalistic conditions one out of two subjects with psychos is interrupts his/her treatment in the months following his/her first disch arge from hospital. Therapeutic programmes aimed at improving medication ad herence should be implemented early in the course of psychosis to reduce th e deleterious consequences of poor medication adherence on clinical outcome .