title: Comparing cognitive functions in medication adherent and non-adherent patients with schizophrenia.
abstract: BACKGROUND
  Medication non-adherence presents a considerable problem in patients with schizophrenia. Cognitive and executive functions can affect adherence. The association between medication non-adherence and cognitive impairment in schizophrenia is under investigated with limited and conflicting research data.
  
  
  OBJECTIVE
  To prospectively assess the rate of drug adherence among a sample of patients with schizophrenia and to compare the cognitive and executive functions between adherent and non-adherent patients.
  
  
  METHODS
  109 patients with schizophrenia diagnosed according to the DSM-IV classification were initially assessed by the Wechsler Adult Intelligence Scale (WAIS), Wechsler Memory Scale-Revised (WMS-R) and Wisconsin Card Sorting Test (WCST) and six months later by the Brief Adherence Rating Scale (BARS).
  
  
  RESULTS
  68.8% were non-adherent to their antipsychotic medication. Adherent patients (31.2%) had significantly higher mean scores for the total, verbal and performance IQ. They had significantly higher mean scores in most of WMS subtests (orientation, information, verbal paired association, digit span, visual memory span), and higher mean scores for; total correct, conceptual level response, percentage and categories completed on the WSCT subscales (P < 0.0001). Whereas the non-adherent group had higher mean scores in; trials administered, total errors, perseverative responses, and perseverative errors (P < 0.0001). In a step regression analysis, digit span, conceptualization, total and percentage of errors were putative predictors of non-adherence.
  
  
  CONCLUSIONS
  Cognitive deficits, especially verbal memory and executive functions were the strongest patients' related factors associated with non adherence to medication. Psychiatrists ought to consider possible cognitive factors influencing adherence to enable offering proper interventions.
authors.affiliation: Institute of Psychiatry, The WHO Collaborating Center for Mental Health Research & Training, Ain Shams University, Department of Neuropsychiatry, Abbasseyia, Ramses Street Extension, P.O. Box: 11657 Dair Al-Malak, Cairo, Egypt. Electronic address: info@elmissiry.com.
authors.forename: Ahmed
authors.initials: A
authors.lastname: El-Missiry
authors.affiliation: Institute of Psychiatry, The WHO Collaborating Center for Mental Health Research & Training, Ain Shams University, Department of Neuropsychiatry, Abbasseyia, Ramses Street Extension, P.O. Box: 11657 Dair Al-Malak, Cairo, Egypt.
authors.forename: Amira
authors.initials: A
authors.lastname: Elbatrawy
authors.affiliation: Institute of Psychiatry, The WHO Collaborating Center for Mental Health Research & Training, Ain Shams University, Department of Neuropsychiatry, Abbasseyia, Ramses Street Extension, P.O. Box: 11657 Dair Al-Malak, Cairo, Egypt.
authors.forename: Marwa
authors.initials: M
authors.lastname: El Missiry
authors.affiliation: Institute of Psychiatry, The WHO Collaborating Center for Mental Health Research & Training, Ain Shams University, Department of Neuropsychiatry, Abbasseyia, Ramses Street Extension, P.O. Box: 11657 Dair Al-Malak, Cairo, Egypt.
authors.forename: Dalia Abdel
authors.initials: DA
authors.lastname: Moneim
authors.affiliation: Institute of Psychiatry, The WHO Collaborating Center for Mental Health Research & Training, Ain Shams University, Department of Neuropsychiatry, Abbasseyia, Ramses Street Extension, P.O. Box: 11657 Dair Al-Malak, Cairo, Egypt.
authors.forename: Ramy
authors.initials: R
authors.lastname: Ali
authors.affiliation: Institute of Psychiatry, The WHO Collaborating Center for Mental Health Research & Training, Ain Shams University, Department of Neuropsychiatry, Abbasseyia, Ramses Street Extension, P.O. Box: 11657 Dair Al-Malak, Cairo, Egypt.
authors.forename: Heba
authors.initials: H
authors.lastname: Essawy
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects; D056344:Executive Function / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008568:Memory / Q000187:drug effects; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D013067:Speech Perception / Q000187:drug effects
chemical_list: D014150:Antipsychotic Agents
keywords: Adherence; Cognitive functions; Memory; Schizophrenia