title: Predictors of medication discontinuation by patients with first-episode schizophrenia and schizoaffective disorder.
abstract: BACKGROUND
  Enhancing medication adherence early in the course of schizophrenia and schizoaffective disorder may substantially improve long-term course. Although extensively studied in multi-episode patients, little data exist on medication adherence by first-episode patients.
  
  
  METHODS
  Medication adherence was assessed during the first year of treatment and following recovery from the first relapse in patients treated by a standardized medication algorithm.
  
  
  RESULTS
  During the first year of treatment, patients with poorer premorbid cognitive functioning were more likely to stop antipsychotics (t=-2.54, df=75, p=0.01). Parkinsonian side effects increased the likelihood (hazard ratio=41.22; 95% CI=2.30, 737.89; p=0.01), and better executive function decreased the likelihood (hazard ratio=0.40; 95% CI=0.18, 0.88; p=0.02) that patients discontinued maintenance medication after a first relapse.
  
  
  CONCLUSIONS
  Interventions to ameliorate cognitive deficits and Parkinsonian side effects may enhance treatment adherence.
authors.affiliation: Department of Psychiatry Research, Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, New York 11004, USA. robinson@lij.edu
authors.forename: Delbert G
authors.initials: DG
authors.lastname: Robinson
authors.forename: Margaret G
authors.initials: MG
authors.lastname: Woerner
authors.forename: Jose Ma J
authors.initials: JM
authors.lastname: Alvir
authors.forename: Robert M
authors.initials: RM
authors.lastname: Bilder
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Hinrichsen
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Lieberman
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000209:etiology; D004409:Dyskinesia, Drug-Induced; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D010349:Patient Compliance; D016016:Proportional Hazards Models; D011618:Psychotic Disorders / Q000188:drug therapy*; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy*; D012959:Socioeconomic Factors; D014481:United States
chemical_list: D014150:Antipsychotic Agents