No adherencia en pacientes con esquizofrenia y trastorno esquizoafectivo. Estudio prospectivo de variables asociadas y posibles subtipos

Abstract

Introduction

The rate of non-adherence to treatment in schizophrenia is between 40 and 50%. The scarcity of consistently identified variables associated with nonadherence could be due to real heterogeneity among nonadherent patients.

Objectives

Evaluate the prevalence of non-adherence in patients with schizophrenia or schizoaffective disorder. Evaluate the possible subtypes of non-adherence according to intentionality.

Methodology

110 consecutively admitted patients diagnosed with schizophrenia and schizoaffective disorder were included. They were evaluated during admission and six months after hospital discharge. Sociodemographic, clinical, psychopathological, and treatment-related variables were included. Adherence was defined as the concurrence of adherence to antipsychotic treatment and follow-up. The subtype of non-adherence was established according to the main reason for non-adherence.

Results

Non-adherence was found in 58.2% of the patients. Low socioeconomic status, cannabis use, nonadherence as a reason for relapse and admission, and severity of symptoms were independently associated with nonadherence. Low educational level, poorer treatment knowledge at six months, and use of non-psychiatric treatment at six months were independently associated with the subtype of unintentional non-adherence.

Conclusions

A high percentage of patients with schizophrenia and schizoaffective disorder do not show adherence after hospital discharge. There seem to be subtypes of non-adherence according to the intention, which suggests the need for a differentiated approach.