Factors affecting treatment compliance in patients with bipolar I disorder during prophylaxis: a study from Turkey

• Published in: General hospital psychiatry 2014-03, Vol.36 (2), p.208-213
• Main Authors: Col, Saime Esra, M.D, Caykoylu, Ali, M.D, Karakas Ugurlu, Gorkem, M.D, Ugurlu, Mustafa, M.D
• Format: Article
• Language: English
• Subjects: Adult; Age of Onset; Antimanic Agents - therapeutic use; Biological and medical sciences; Bipolar Disorder - drug therapy; Bipolar Disorder - epidemiology; Bipolar Disorder - prevention & control; Case-Control Studies; Compliance; Dipolar disorder; Female; Hospitalization - statistics & numerical data; Humans; Lithium Compounds - therapeutic use; Logistic Models; Male; Medical sciences; Medication; Medication Adherence - psychology; Medication Adherence - statistics & numerical data; Middle Aged; Neuropharmacology; Pharmacology. Drug treatments; Physician-Patient Relations; Psychiatry; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Risk Factors; Secondary Prevention; Social Support; Socioeconomic Factors; Time-to-Treatment; Turkey; Valproic Acid - therapeutic use
• ISSN: 0163-8343; 1873-7714
• DOI: 10.1016/j.genhosppsych.2013.11.006

Abstract Objectives Treatment noncompliance is one of the most frequent causes of relapse and recurrence in patients with bipolar I disorder. Treatment compliance among patients with bipolar disorder is affected by individual patients’ features, the disease itself, doctor-patient relationships and patients’ socio-economic and cultural characteristics. This study aimed to determine the factors affecting treatment compliance during the treatment of bipolar disorder and contribute to current clinical strategies. Methods Data were collected from 78 volunteers with bipolar I disorder in remission; all volunteers were being treated solely with mood stabilisers. Sociodemographic and clinical data were gathered through a semi-structured interview designed by researchers. The Hamilton Depression Rating Scale and the Young Mania Rating Scale were both administered to assess remission of bipolar I disorder, and a self-report scale, the Medication Adherence Rating Scale, was administered to assess medication adherence. Results Treatment compliant patients reported that they had received adequate social support and had been sufficiently informed by their physicians about the illness and treatment. Treatment compliant individuals with higher rates of hospitalisations and the results indicate that the number of depressive episodes adversely affects treatment compliance. There was not a statistically significant difference in treatment compliance based on duration of illness, euthymia, time, total number of episodes, age of onset, predominant polarity, drug doses, number of daily medications, frequency of daily medications, or type of mood stabiliser used. Conclusions These results indicate that there are differences between compliant and non-compliant bipolar I disorder patients in terms of adequate social support, information provided by the physician about the illness and treatment, number of depressive episodes and number of hospitalisations.