title: Treatment adherence and quality of sleep in schizophrenia outpatients.
abstract: OBJECTIVE
  Patients with schizophrenia (SZ) often present sleep complaints, and patients with sleep disturbances are at a greater risk for symptom worsening after antipsychotic discontinuation. Long-term adherence to antipsychotic treatment remains a challenge for clinicians, and the relationship between quality of sleep and treatment adherence in SZ outpatients has been poorly studied.
  
  
  METHODS
  In this cross-sectional, non-interventional study, 811 adult outpatients with a diagnosis of SZ were divided into two groups according to the presence (or absence) of sleep disturbances, and assessed using measures of symptom severity, quality and patterns of sleep, adherence/compliance to treatment, and family support degree.
  
  
  RESULTS
  Patients with sleep disturbances were significantly more symptomatic (p < 0.0001), and scored significantly higher on the Pittsburgh Sleep Quality Index (PSQI) as compared with patients without sleep disturbances (p < 0.0001). More compliant patients showed less sleep disturbances (p < 0.0001); moreover, patients with worse compliance to pharmacological treatment showed significantly higher scores on the PSQI (p < 0.0001). Regarding family support degree, patients with sleep disorders presented a lower family support (p = 0.0236), and patients with worse treatment adherence had worse family support (p < 0.0001).
  
  
  CONCLUSIONS
  Our findings show that SZ outpatients reporting sleep disturbances show greater symptom severity, and worse adherence/compliance to treatment, as well as a lower family support.
authors.affiliation: Lisbon's Psychiatric Hospitalar Center , Lisbon , Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Afonso
authors.forename: Sofia
authors.initials: S
authors.lastname: Brissos
authors.forename: Fernando
authors.initials: F
authors.lastname: Cañas
authors.forename: Julio
authors.initials: J
authors.lastname: Bobes
authors.forename: Ivan
authors.initials: I
authors.lastname: Bernardo-Fernandez
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D010045:Outpatients / Q000706:statistics & numerical data; D012008:Recurrence; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology*; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D012890:Sleep / Q000187:drug effects; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D012944:Social Support; D016903:Drug Monitoring
chemical_list: D014150:Antipsychotic Agents