Depot-medication compliance for patients with psychotic disorders: the importance of illness insight and treatment motivation

Ernst L Noordraven,1,2 André I Wierdsma,2 Peter Blanken,3 Anthony F T Bloemendaal,1 Cornelis L Mulder2,4 1Dual Diagnosis Centre (CDP), Parnassia Psychiatric Institute, the Hague, 2Department of Psychiatry, Erasmus University Medical Center, Rotterdam, 3Parnassia Addiction Research Centre...

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Autores principales:	Noordraven EL, Wierdsma AI, Blanken P, Bloemendaal AFT, Mulder CL
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Non-compliance psychotic disorder illness insight motivation depot medication Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/c684057cdf0c4721a9496441d9bd5be6
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spelling	oai:doaj.org-article:c684057cdf0c4721a9496441d9bd5be62021-12-02T00:44:56ZDepot-medication compliance for patients with psychotic disorders: the importance of illness insight and treatment motivation1178-2021https://doaj.org/article/c684057cdf0c4721a9496441d9bd5be62016-02-01T00:00:00Zhttps://www.dovepress.com/depot-medication-compliance-for-patients-with-psychotic-disorders-the--peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Ernst L Noordraven,1,2 André I Wierdsma,2 Peter Blanken,3 Anthony F T Bloemendaal,1 Cornelis L Mulder2,4 1Dual Diagnosis Centre (CDP), Parnassia Psychiatric Institute, the Hague, 2Department of Psychiatry, Erasmus University Medical Center, Rotterdam, 3Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, the Hague, 4Bavo-Europoort Mental Health Care, Parnassia Psychiatric Institute, Rotterdam, the Netherlands Background: Noncompliance is a major problem for patients with a psychotic disorder. Two important risk factors for noncompliance that have a severe negative impact on treatment outcomes are impaired illness insight and lack of motivation. Our cross-sectional study explored how they are related to each other and their compliance with depot medication. Methods: Interviews were conducted in 169 outpatients with a psychotic disorder taking depot medication. Four patient groups were defined based on low or high illness insight and on low or high motivation. The associations between depot-medication compliance, motivation, and insight were illustrated using generalized linear models. Results: Generalized linear model showed a significant interaction effect between motivation and insight. Patients with poor insight and high motivation for treatment were more compliant (94%) (95% confidence interval [CI]: 1.821, 3.489) with their depot medication than patients with poor insight and low motivation (61%) (95% CI: 0.288, 0.615). Patients with both insight and high motivation for treatment were less compliant (73%) (95% CI: 0.719, 1.315) than those with poor insight and high motivation. Conclusion: Motivation for treatment was more strongly associated with depot-medication compliance than with illness insight. Being motivated to take medication, whether to get better or for other reasons, may be a more important factor than having illness insight in terms of improving depot-medication compliance. Possible implications for clinical practice are discussed. Keywords: noncompliance, psychotic disorder, illness insight, motivation, depot medication, schizophreniaNoordraven ELWierdsma AIBlanken PBloemendaal AFTMulder CLDove Medical PressarticleNon-compliancepsychotic disorderillness insightmotivationdepot medicationNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2016, Iss Issue 1, Pp 269-274 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Non-compliance psychotic disorder illness insight motivation depot medication Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Non-compliance psychotic disorder illness insight motivation depot medication Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Noordraven EL Wierdsma AI Blanken P Bloemendaal AFT Mulder CL Depot-medication compliance for patients with psychotic disorders: the importance of illness insight and treatment motivation
description	Ernst L Noordraven,1,2 André I Wierdsma,2 Peter Blanken,3 Anthony F T Bloemendaal,1 Cornelis L Mulder2,4 1Dual Diagnosis Centre (CDP), Parnassia Psychiatric Institute, the Hague, 2Department of Psychiatry, Erasmus University Medical Center, Rotterdam, 3Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, the Hague, 4Bavo-Europoort Mental Health Care, Parnassia Psychiatric Institute, Rotterdam, the Netherlands Background: Noncompliance is a major problem for patients with a psychotic disorder. Two important risk factors for noncompliance that have a severe negative impact on treatment outcomes are impaired illness insight and lack of motivation. Our cross-sectional study explored how they are related to each other and their compliance with depot medication. Methods: Interviews were conducted in 169 outpatients with a psychotic disorder taking depot medication. Four patient groups were defined based on low or high illness insight and on low or high motivation. The associations between depot-medication compliance, motivation, and insight were illustrated using generalized linear models. Results: Generalized linear model showed a significant interaction effect between motivation and insight. Patients with poor insight and high motivation for treatment were more compliant (94%) (95% confidence interval [CI]: 1.821, 3.489) with their depot medication than patients with poor insight and low motivation (61%) (95% CI: 0.288, 0.615). Patients with both insight and high motivation for treatment were less compliant (73%) (95% CI: 0.719, 1.315) than those with poor insight and high motivation. Conclusion: Motivation for treatment was more strongly associated with depot-medication compliance than with illness insight. Being motivated to take medication, whether to get better or for other reasons, may be a more important factor than having illness insight in terms of improving depot-medication compliance. Possible implications for clinical practice are discussed. Keywords: noncompliance, psychotic disorder, illness insight, motivation, depot medication, schizophrenia
format	article
author	Noordraven EL Wierdsma AI Blanken P Bloemendaal AFT Mulder CL
author_facet	Noordraven EL Wierdsma AI Blanken P Bloemendaal AFT Mulder CL
author_sort	Noordraven EL
title	Depot-medication compliance for patients with psychotic disorders: the importance of illness insight and treatment motivation
title_short	Depot-medication compliance for patients with psychotic disorders: the importance of illness insight and treatment motivation
title_full	Depot-medication compliance for patients with psychotic disorders: the importance of illness insight and treatment motivation
title_fullStr	Depot-medication compliance for patients with psychotic disorders: the importance of illness insight and treatment motivation
title_full_unstemmed	Depot-medication compliance for patients with psychotic disorders: the importance of illness insight and treatment motivation
title_sort	depot-medication compliance for patients with psychotic disorders: the importance of illness insight and treatment motivation
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/c684057cdf0c4721a9496441d9bd5be6
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Depot-medication compliance for patients with psychotic disorders: the importance of illness insight and treatment motivation

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