title: Comparing medication attitudes and reasons for medication nonadherence among three disparate groups of individuals with serious mental illness.
abstract: This analysis compared medication attitudes and reasons for nonadherence in three distinct groups of patients with serious mental illness (SMI). Cohort 1 had 43 patients with bipolar disorder (BD) treated in a community mental health setting, cohort 2 had 43 patients with BD taking an atypical antipsychotic and treated in an academic medical center, and cohort 3 had 30 patients with schizophrenia or schizoaffective disorder who had been homeless in the last year. Standardized attitudinal scales found generally negative attitudes toward medication and limited illness insight. Although the three cohorts differed with regard to severity of symptoms, age of onset, education, baseline adherence, and race, the groups had similar medication attitudes before and after treatment. Despite group differences in demographic and clinical variables, our analyses found more similarities than differences in medication attitudes among these three discrete groups of poorly adherent, symptomatic patients with SMI. The common attitudinal characteristics have implications for delivery of health care services that can enhance treatment adherence in high-risk SMI patients.
authors.affiliation: *Department of Psychiatry, Case Western Reserve University School of Medicine; †Neurological and Behavioral Outcomes Center, University Hospitals Case Medical Center; and ‡Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH.
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: Levin
authors.forename: Nasim
authors.initials: N
authors.lastname: Seifi
authors.forename: Kristin A
authors.initials: KA
authors.lastname: Cassidy
authors.forename: Curtis
authors.initials: C
authors.lastname: Tatsuoka
authors.forename: Johnny
authors.initials: J
authors.lastname: Sams
authors.forename: Kouri K
authors.initials: KK
authors.lastname: Akagi
authors.forename: Martha
authors.initials: M
authors.lastname: Sajatovic
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001714:Bipolar Disorder / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D012559:Schizophrenia / Q000188:drug therapy / Q000453:epidemiology*; D012565:Schizophrenic Psychology; D011795:Surveys and Questionnaires