title: Non-adherence to Psychotropic Medication Among Adolescents - A Systematic Review of the Literature.
abstract: Whether patients take their medication as prescribed is of increasing importance in adolescent psychiatry since both the number of efficacious pharmaceutical treatments and the rate of prescriptions of psychotropic compounds are on the rise. Previous research showed high rates of medication nonadherence among both adolescents with medical disorders and adult patients with psychiatric disorders.
  
  
  
  The present review was performed according to PRISMA guidelines and evaluates existing scientific literature concerning adherence to psychotropic medication among adolescents. The goal was to determine rates of nonadherence in this age group as well as the factors associated with it. Therefore, we conducted a comprehensive literature search of PubMed from its inception until 15 September 2015 using the keywords "adherence," "compliance," "adolescent," and "psychotropic medication."
  
  
  
  A total of 607 pertinent articles were collected and screened; 15 publications were selected for detailed review. The studies differed, among other things, regarding sample characteristics, medication type, and indications. Furthermore, the definitions of what constitutes nonadherence and the methods used to assess it varied widely. Nonadherence rates ranged from 6 % to 62 % (median 33 %).
  
  
  
  Nonadherence to psychotropic medication is a clinically relevant problem among adolescents. Because of the methodological heterogeneity across studies and partially contradictory results, no conclusions could be drawn concerning the influence of factors such as psychopathology, medication type, side effects, the effectiveness of treatment, or family-related factors. Well-designed long-term studies of large patient samples and a consensus regarding definitions are therefore warranted. Such research would facilitate the design of tailored strategies to improve adherence in these patients.
authors.affiliation: 1 Research Group of Pediatric Psychopharmacology, Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Häge
authors.affiliation: 1 Research Group of Pediatric Psychopharmacology, Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany.
authors.forename: Lisa
authors.initials: L
authors.lastname: Weymann
authors.affiliation: 1 Research Group of Pediatric Psychopharmacology, Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany.
authors.forename: Lucia
authors.initials: L
authors.lastname: Bliznak
authors.affiliation: 2 Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Germany.
authors.forename: Viktoria
authors.initials: V
authors.lastname: Märker
authors.affiliation: 1 Research Group of Pediatric Psychopharmacology, Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany.
authors.forename: Konstantin
authors.initials: K
authors.lastname: Mechler
authors.affiliation: 1 Research Group of Pediatric Psychopharmacology, Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany.
authors.forename: Ralf W
authors.initials: RW
authors.lastname: Dittmann
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy; D006801:Humans; D008134:Long-Term Care; D055118:Medication Adherence / Q000523:psychology*; D001523:Mental Disorders / Q000188:drug therapy* / Q000523:psychology*; D011599:Psychopathology; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use*; D013223:Statistics as Topic
chemical_list: D011619:Psychotropic Drugs
keywords: Compliance; compliance; nonadherence; operational definition.; partial adherence; psychotropic medication