title: Treatment adherence towards prescribed medications in bipolar-II acute depressed patients: relationship with cyclothymic temperament and "therapeutic sensation seeking" in response towards subjective intolerance to pain.
abstract: BACKGROUND
  Treatment adherence (TA) is crucial during almost any phase of bipolar disorder (BD), including type-II (BD-II) acute depression. While a number of issues have been traditionally accounted on the matter, additional factors should be likewise involved, including affective temperaments and some clinically suggestive psychopathological traits whose systematic assessment represents the aim of this study.
  
  
  METHODS
  Two hundred and twenty BD-II acute depressed outpatients were consecutively evaluated using the Structured Clinical Interviews for Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition Axis-I and II Disorders, Hamilton scales for Depression and Anxiety, Temperament Evaluation of the Memphis Pisa Paris San Diego-Auto-questionnaire-110-item, Visual Analogue Scale (VAS), Zuckerman's Sensation-Seeking Scale-Form-V (SSS-V), Barratt's Impulsivity Scale-11-item, State-Trait Anxiety Inventory modules, Severity module of the Clinical Global Impression Scale for BD, Morisky 8-Item Medication Adherence Scale (MMAS-8) and the Clinician Rating Scale (CRS). Patients were divided into non-adherent vs. treatment-adherent cases depending on MMAS-8+CRS scores.
  
  
  RESULTS
  In the TA(-) group, higher VAS and cyclothymic temperament scores were highly correlated (r=.699; p≤.001). Those latter scores, along with SSS-V scores and the occurrence of lifetime addiction to painkiller and/or homeopathic medications available over the counter defined a "therapeutic sensation seeking" pattern allowing to correctly classify as much as 93.9% [Exp(B)=3.490; p≤.001] of TA(-) cases (49/220).
  
  
  CONCLUSIONS
  Lack of objective TA measures and systematic pharmacological record; recall bias on some diagnoses; and relatively small sample size.
  
  
  CONCLUSIONS
  Stating the burden of TA in BD, additional studies on this regard are aimed, ideally contributing to enhance the management of BD itself.
authors.affiliation: Department of Educational Sciences, University of Catania, via Ofelia n.1, Zip 95125, Catania, Italy. Electronic address: Dott.Fornaro@gmail.com.
authors.forename: Michele
authors.initials: M
authors.lastname: Fornaro
authors.affiliation: Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, "ASL 4", Teramo, Italy. Electronic address: dodebera@aliceposta.it.
authors.forename: Domenico
authors.initials: D
authors.lastname: De Berardis
authors.affiliation: Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine Federico II, Naples, Italy. Electronic address: felix_ias@hotmail.com.
authors.forename: Felice
authors.initials: F
authors.lastname: Iasevoli
authors.affiliation: Department of Educational Sciences, University of Catania, via Ofelia n.1, Zip 95125, Catania, Italy. Electronic address: m.luisapistorio@libero.it.
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Pistorio
authors.affiliation: National Health System, Genoa, Italy. Electronic address: dangelo1980@hotmail.com.
authors.forename: Emanuela
authors.initials: E
authors.lastname: D'Angelo
authors.affiliation: National Health System, Genoa, Italy. Electronic address: sergiomungo@libero.it.
authors.forename: Sergio
authors.initials: S
authors.lastname: Mungo
authors.affiliation: Department of Psychiatry, University of Genova, Genoa, Italy. Electronic address: matteomartino9@gmail.com.
authors.forename: Matteo
authors.initials: M
authors.lastname: Martino
authors.affiliation: Department of Psychiatry, University of Foggia, Foggia, Italy. Electronic address: dr.ventriglio@gmail.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ventriglio
authors.affiliation: National Health System, "ASL 13", Novara, Italy. Electronic address: carloignaziocattaneo@alice.it.
authors.forename: Carlo Ignazio
authors.initials: CI
authors.lastname: Cattaneo
authors.affiliation: National Health System, "Bressanone Hospital", Bolzano, Italy. Electronic address: ettore.favaretto@sb-brixen.it.
authors.forename: Ettore
authors.initials: E
authors.lastname: Favaretto
authors.affiliation: Department of Psychiatry, University of Pisa, Pisa, Italy. Electronic address: adeldebbio@gmail.com.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Del Debbio
authors.affiliation: Department of Psychiatry, University of Pisa, Pisa, Italy. Electronic address: annaromano21@libero.it.
authors.forename: Anna
authors.initials: A
authors.lastname: Romano
authors.affiliation: Department of Psychiatry, University of Pisa, Pisa, Italy. Electronic address: ciampagiovanni1@gmail.com.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ciampa
authors.affiliation: Department of Psychiatry, Mansoura University, Egypt. Electronic address: elassym@gmail.com.
authors.forename: Mai
authors.initials: M
authors.lastname: Elassy
authors.affiliation: Department of Psychiatry, University of Pisa, Pisa, Italy. Electronic address: giulio.perugi@med.unipi.it.
authors.forename: Giulio
authors.initials: G
authors.lastname: Perugi
authors.affiliation: Department of Educational Sciences, University of Catania, via Ofelia n.1, Zip 95125, Catania, Italy. Electronic address: depasqua@unict.it.
authors.forename: Concetta
authors.initials: C
authors.lastname: De Pasquale
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D011795:Surveys and Questionnaires; D013694:Temperament; D055815:Young Adult
keywords: Acute depression; Bipolar disorder; Cyclothymic temperament; Sensation seeking; Treatment adherence