Adherence predicts symptomatic and psychosocial remission in schizophrenia: Naturalistic study of patient integration in the community.
BACKGROUND
Psychosocial functioning in patients with schizophrenia attended in daily practice is an understudied aspect. The aim of this study was to assess the relationship between symptomatic and psychosocial remission and adherence to treatment in schizophrenia.


METHODS
This cross-sectional, non-interventional, and multicenter study assessed symptomatic and psychosocial remission and community integration of 1,787 outpatients with schizophrenia attended in Spanish mental health services. Adherence to antipsychotic medication in the previous year was categorized as≥80% vs.<80%.


RESULTS
Symptomatic remission was achieved in 28.5% of patients, and psychosocial remission in 26.1%. A total of 60.5% of patients were classified as adherent to antipsychotic treatment and 41% as adherent to non-pharmacological treatment. During the index visit, treatment was changed in 28.4% of patients, in 31.1% of them because of low adherence (8.8% of the total population). Adherent patients showed higher percentages of symptomatic and psychosocial remission than non-adherent patients (30.5 vs. 25.4%, P<.05; and 32 vs. 17%, P<.001, respectively). Only 3.5% of the patients showed an adequate level of community integration, which was also higher among adherent patients (73.0 vs. 60.1%, P<.05).


CONCLUSIONS
Adherence to antipsychotic medication was associated with symptomatic and psychosocial remission as well as with community integration.
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, España.
Miguel
M
Bernardo
Hospital Dr. Rodríguez Lafora, Madrid, España.
Fernando
F
Cañas
Medical Affairs Department, Janssen-Cilag, S. A., Madrid, España. Electronic address: bherrer1@its.jnj.com.
Berta
B
Herrera
Medical Affairs Department, Janssen-Cilag, S. A., Madrid, España.
Marta
M
García Dorado
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D062309:Community Integration / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome; D016903:Drug Monitoring
D014150:Antipsychotic Agents
Adherence; Adherencia; Community integration; Esquizofrenia; Funcionamiento psicosocial; Integración comunitaria; Psychosocial functioning; Psychosocial remission; Remisión psicosocial; Schizophrenia