title: Risk factors for antipsychotic medication non-adherence behaviors and attitudes in adult-onset psychosis.
abstract: Research on antipsychotic medication non-adherence in first-episode psychosis patients tends to examine non-adherence behaviors and attitudes together. Nonetheless, attitudes do not always directly translate into behaviors. We examined the baseline predictors for antipsychotics non-adherence behaviors and attitudes separately in a first-episode psychosis cohort. We also included cognitive impairments as one of the predictor variables as this domain is rarely explored in adherence studies.
  
  
  
  Participants were 313 adult-onset psychosis patients recruited from the Jockey Club Early Psychosis project in Hong Kong. Demographic, premorbid, clinical, and cognitive characteristics were first assessed at baseline. Six months later, participants completed a 14-item Medication Compliance Questionnaire, which was a modified and Cantonese-translated version of the Medication Adherence Rating Scale that includes items pertaining to both adherence behaviors and attitudes.
  
  
  
  Rates of poor adherence behaviors and negative adherence attitudes were 17.6% and 27.8%, respectively. Determinants of poor adherence behavior included more severe positive symptoms, hospitalization at onset of illness, and poorer engagement in extended social network. As for negative adherence attitude, determinants included more severe general psychopathology, poorer insight, more psychic medication side-effects, and poorer performance on backward digit span test and WAIS-R information test.
  
  
  
  The risk factors for non-adherence behaviors and attitudes are different and they should all be taken into careful consideration while formulating appropriate intervention programs to tackle the adherence problem in adult onset psychosis.
authors.affiliation: Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China. Electronic address: christy@lmhui.com.
authors.forename: Christy Lai Ming
authors.initials: CLM
authors.lastname: Hui
authors.affiliation: Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Venessa Wing Yan
authors.initials: VWY
authors.lastname: Poon
authors.affiliation: Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Wai Tung
authors.initials: WT
authors.lastname: Ko
authors.affiliation: Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Ho Yee
authors.initials: HY
authors.lastname: Miao
authors.affiliation: Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Wing Chung
authors.initials: WC
authors.lastname: Chang
authors.affiliation: Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Edwin Ho Ming
authors.initials: EHM
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Sherry Kit Wa
authors.initials: SKW
authors.lastname: Chan
authors.affiliation: Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Jingxia
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Eric Yu Hai
authors.initials: EYH
authors.lastname: Chen
mesh_terms: D000328:Adult; D017668:Age of Onset; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001294:Attitude to Health; D060825:Cognitive Dysfunction / Q000209:etiology; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D014150:Antipsychotic Agents
keywords: Adherence; Antipsychotics; First-episode; Predictors; Psychosis