title: A comparison of treatment adherence in individuals with a first episode of psychosis and inpatients with psychosis.
abstract: In predicting treatment compliance in individuals with severe mental illness, research has focused on variables such as substance abuse, personality, history of child abuse, and symptomatology, although these relationships have not been investigated in great detail in individuals at the onset of mental illness. To better understand these correlates of treatment compliance, two samples were examined: a sample of 117 individuals presenting with a first episode of psychosis and a more chronic forensic sample of 65 participants recruited from a psychiatric hospital. These samples were investigated for service engagement in terms of violence history, substance abuse, symptom severity, psychopathic traits and history of childhood abuse. Linear regressions performed for the first episode sample revealed that childhood physical abuse was the strongest predictor of poor service engagement, followed by problems with alcohol, a history of physical violence, any history of violence and higher psychopathic traits. Linear regression revealed for the forensic group that a lower level of service engagement was most strongly predicted by a history of childhood abuse and a higher score on the Brief Psychiatric Rating Scale (BPRS). Results are presented in light of the existing literature and clinical implications are discussed.
authors.affiliation: University of Montreal, Canada. Electronic address: aliciaspidel@aim.com.
authors.forename: Alicia
authors.initials: A
authors.lastname: Spidel
authors.affiliation: BC Mental Health & Addiction Services, Canada; The University of British Columbia, Canada.
authors.forename: Caroline
authors.initials: C
authors.lastname: Greaves
authors.affiliation: Forensic Alliance, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Yuille
authors.affiliation: University of Montreal, Canada.
authors.forename: Tania
authors.initials: T
authors.lastname: Lecomte
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D001955:British Columbia / Q000453:epidemiology; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D007297:Inpatients; D007406:Interview, Psychological; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales; D011599:Psychopathology; D011618:Psychotic Disorders / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D012307:Risk Factors; D057566:Self Report; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Compliance; Psychosis; Trauma; Violence and psychopathy