Abstract
Objective: This study examined the effect of medication nonadherence on the return of positive symptoms among recent-onset schizophrenia patients. Method: Three sets of operational criteria for medication nonadherence with differing levels of severity were compared for their ability to predict relapse. Explicit operational criteria are provided with the hope that they will be adopted by others. Psychotic symptoms were prospectively rated on a frequent basis, and systematic criteria were applied using a computer scoring program to identify periods of psychotic symptom return. In addition, a specialized statistical survival analysis method, optimal for examining risk periods and outcomes that can recur during the follow-up assessment, was used. Results: As hypothesized, medication nonadherence robustly predicted a return of psychotic symptoms during the early phase of schizophrenia (hazard ratios=3.7-28.5, depending on the severity of nonadherence). Conclusions: Even brief periods of partial nonadherence lead to greater risk of relapse than what is commonly assumed. Patients in the early phase of schizophrenia should be cautioned about the possible consequences of partial or relatively brief periods of antipsychotic medication nonadherence.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 286-292 |
| Number of pages | 7 |
| Journal | American Journal of Psychiatry |
| Volume | 168 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 2011 |
| Externally published | Yes |
Fingerprint
ASJC Scopus subject areas
- Psychiatry and Mental health
Cite this
Risperidone nonadherence and return of positive symptoms in the early course of schizophrenia. / Subotnik, Kenneth L.; Nuechterlein, Keith H.; Ventura, Joseph; Gitlin, Michael J.; Stephen, Marder; Mintz, Jim; Hellemann, Gerhard S.; Thornton, Leslie A.; Singh, Indira R.
In: American Journal of Psychiatry, Vol. 168, No. 3, 03.2011, p. 286-292.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Risperidone nonadherence and return of positive symptoms in the early course of schizophrenia
AU - Subotnik, Kenneth L.
AU - Nuechterlein, Keith H.
AU - Ventura, Joseph
AU - Gitlin, Michael J.
AU - Stephen, Marder
AU - Mintz, Jim
AU - Hellemann, Gerhard S.
AU - Thornton, Leslie A.
AU - Singh, Indira R.
PY - 2011/3
Y1 - 2011/3
N2 - Objective: This study examined the effect of medication nonadherence on the return of positive symptoms among recent-onset schizophrenia patients. Method: Three sets of operational criteria for medication nonadherence with differing levels of severity were compared for their ability to predict relapse. Explicit operational criteria are provided with the hope that they will be adopted by others. Psychotic symptoms were prospectively rated on a frequent basis, and systematic criteria were applied using a computer scoring program to identify periods of psychotic symptom return. In addition, a specialized statistical survival analysis method, optimal for examining risk periods and outcomes that can recur during the follow-up assessment, was used. Results: As hypothesized, medication nonadherence robustly predicted a return of psychotic symptoms during the early phase of schizophrenia (hazard ratios=3.7-28.5, depending on the severity of nonadherence). Conclusions: Even brief periods of partial nonadherence lead to greater risk of relapse than what is commonly assumed. Patients in the early phase of schizophrenia should be cautioned about the possible consequences of partial or relatively brief periods of antipsychotic medication nonadherence.
AB - Objective: This study examined the effect of medication nonadherence on the return of positive symptoms among recent-onset schizophrenia patients. Method: Three sets of operational criteria for medication nonadherence with differing levels of severity were compared for their ability to predict relapse. Explicit operational criteria are provided with the hope that they will be adopted by others. Psychotic symptoms were prospectively rated on a frequent basis, and systematic criteria were applied using a computer scoring program to identify periods of psychotic symptom return. In addition, a specialized statistical survival analysis method, optimal for examining risk periods and outcomes that can recur during the follow-up assessment, was used. Results: As hypothesized, medication nonadherence robustly predicted a return of psychotic symptoms during the early phase of schizophrenia (hazard ratios=3.7-28.5, depending on the severity of nonadherence). Conclusions: Even brief periods of partial nonadherence lead to greater risk of relapse than what is commonly assumed. Patients in the early phase of schizophrenia should be cautioned about the possible consequences of partial or relatively brief periods of antipsychotic medication nonadherence.
UR - http://www.scopus.com/inward/record.url?scp=79952732903&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79952732903&partnerID=8YFLogxK
U2 - 10.1176/appi.ajp.2010.09010087
DO - 10.1176/appi.ajp.2010.09010087
M3 - Article
C2 - 21205805
AN - SCOPUS:79952732903
VL - 168
SP - 286
EP - 292
JO - American Journal of Psychiatry
JF - American Journal of Psychiatry
SN - 0002-953X
IS - 3
ER -