title: Variables associated with nonadherence in clinically stable patients with bipolar disorder.
abstract: BACKGROUND
  Nonadherence is an important and highly prevalent issue in bipolar disorder, which may have serious consequences. Surprisingly, few studies have been carried out in patients with clinical stability to explore risk factors for nonadherence.
  
  
  METHODS
  Adherence was assessed in 76 bipolar disorder patients with clinical stability using objective and subjective methods, both with a cross-sectional approach and a 3-year retrospective period. Possible associations between nonadherence and sociodemographic, clinical, treatment-related, psychopathological, psychological-subjective and result variables were also assessed.
  
  
  RESULTS
  36.8% of patients were nonadherent. These patients showed greater concerns about medicines, worse functionality, a greater number of episodes and depressive episodes, higher prevalence of psychiatric comorbidities, present and/or past substance use or abuse and a history of depressive episodes with psychotic symptoms. A multivariate analysis revealed that concern about medicines, present and/or past substance use or abuse and psychiatric comorbidities were independently associated with nonadherence.
  
  
  CONCLUSIONS
  Nonadherence is a frequent phenomenon in bipolar disorder, even in patients with clinical stability. Clinicians should assess patients&#8217; beliefs and attitudes towards medicines and help them reevaluate those issues with a more realistic perspective. Clinicians should also take actions to prevent substance use or abuse. Identification of nonadherence risk profile in bipolar disorder patients in clinical stability, adds complementary information to the identified risk profile in acute phases of the disease.
authors.affiliation: Service of Psychiatry, University Hospital of Gran Canaria Dr. Negrín. Gran Canaria, The Canary Islands, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Navarro
authors.affiliation: Service of Psychiatry, University Hospital of Gran Canaria Dr. Negrín. Gran Canaria, The Canary Islands, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez
authors.affiliation: Mental Health Research Program of the Canary Islands. Service of Mental Health. General Direction of Healthcare Programs. Gran Canaria, The Canary Islands, Spain Research Network for Health Services for Chronic Diseases (Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC)). Health Institute Carlos III. Spain.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Acosta
authors.affiliation: Unidad de Investigación,University Hospital of Gran Canaria Dr. Negrín. Gran Canaria, The Canary Islands, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: García-Bello
mesh_terms: D001714:Bipolar Disorder / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016903:Drug Monitoring