title: Depot-medication compliance for patients with psychotic disorders: the importance of illness insight and treatment motivation.
abstract: BACKGROUND
  Noncompliance is a major problem for patients with a psychotic disorder. Two important risk factors for noncompliance that have a severe negative impact on treatment outcomes are impaired illness insight and lack of motivation. Our cross-sectional study explored how they are related to each other and their compliance with depot medication.
  
  
  METHODS
  Interviews were conducted in 169 outpatients with a psychotic disorder taking depot medication. Four patient groups were defined based on low or high illness insight and on low or high motivation. The associations between depot-medication compliance, motivation, and insight were illustrated using generalized linear models.
  
  
  RESULTS
  Generalized linear model showed a significant interaction effect between motivation and insight. Patients with poor insight and high motivation for treatment were more compliant (94%) (95% confidence interval [CI]: 1.821, 3.489) with their depot medication than patients with poor insight and low motivation (61%) (95% CI: 0.288, 0.615). Patients with both insight and high motivation for treatment were less compliant (73%) (95% CI: 0.719, 1.315) than those with poor insight and high motivation.
  
  
  CONCLUSIONS
  Motivation for treatment was more strongly associated with depot-medication compliance than with illness insight. Being motivated to take medication, whether to get better or for other reasons, may be a more important factor than having illness insight in terms of improving depot-medication compliance. Possible implications for clinical practice are discussed.
authors.affiliation: Dual Diagnosis Centre (CDP), Parnassia Psychiatric Institute, the Hague, the Netherlands; Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Ernst L
authors.initials: EL
authors.lastname: Noordraven
authors.affiliation: Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: André I
authors.initials: AI
authors.lastname: Wierdsma
authors.affiliation: Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, the Hague.
authors.forename: Peter
authors.initials: P
authors.lastname: Blanken
authors.affiliation: Dual Diagnosis Centre (CDP), Parnassia Psychiatric Institute, the Hague, the Netherlands.
authors.forename: Anthony Ft
authors.initials: AF
authors.lastname: Bloemendaal
authors.affiliation: Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands; Bavo-Europoort Mental Health Care, Parnassia Psychiatric Institute, Rotterdam, the Netherlands.
authors.forename: Cornelis L
authors.initials: CL
authors.lastname: Mulder
keywords: depot medication; illness insight; motivation; noncompliance; psychotic disorder; schizophrenia