title: Cannabis use and involuntary admission may mediate long-term adherence in first-episode psychosis patients: a prospective longitudinal study.
abstract: BACKGROUND
  This study aimed to examine factors associated with treatment adherence in first-episode psychosis (FEP) patients followed up over 8 years, especially involuntary first admission and stopping cannabis use.
  
  
  METHODS
  This prospective, longitudinal study of FEP patients collected data on symptoms, adherence, functioning, and substance use. Adherence to treatment was the main outcome variable and was categorized as 'good' or 'bad'. Cannabis use during follow-up was stratified as continued use, stopped use, and never used. Bivariate and logistic regression models identified factors significantly associated with adherence and changes in adherence over the 8-year follow-up period.
  
  
  RESULTS
  Of the 98 FEP patients analyzed at baseline, 57.1% had involuntary first admission, 74.4% bad adherence, and 52% cannabis use. Good adherence at baseline was associated with Global Assessment of Functioning score (p = 0.019), Hamilton Depression Rating Scale score (p = 0.017) and voluntary admission (p < 0.001). Adherence patterns over 8 years included: 43.4% patients always bad, 26.1% always good, 25% improved from bad to good. Among the improved adherence group, 95.7% had involuntary first admission and 38.9% stopped cannabis use. In the subgroup of patients with bad adherence at baseline, involuntary first admission and quitting cannabis use during follow up were associated with improved adherence.
  
  
  CONCLUSIONS
  The long-term association between treatment adherence and type of first admission and cannabis use in FEP patients suggest targets for intervention to improve clinical outcomes.
authors.forename: Sara
authors.initials: S
authors.lastname: Barbeito
authors.forename: Patricia
authors.initials: P
authors.lastname: Vega
authors.forename: Sonia
authors.initials: S
authors.lastname: Ruiz de Azúa
authors.forename: Margarita
authors.initials: M
authors.lastname: Saenz
authors.forename: Mónica
authors.initials: M
authors.lastname: Martinez-Cengotitabengoa
authors.forename: Itxaso
authors.initials: I
authors.lastname: González-Ortega
authors.forename: Cristina
authors.initials: C
authors.lastname: Bermudez
authors.forename: Margarita
authors.initials: M
authors.lastname: Hernanz
authors.forename: Blanca Fernández de
authors.initials: BF
authors.lastname: Corres
authors.affiliation: Biomedical Research Centre in Mental Health Net (CIBERSAM), University Hospital of Álava, Olaguibel Street, Vitoria, Spain. anamaria.gonzalez-pintoarrillaga@osakidetza.net.
authors.forename: Ana
authors.initials: A
authors.lastname: González-Pinto
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008385:Marijuana Smoking / Q000523:psychology*; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology
chemical_list: D014150:Antipsychotic Agents