The effect of motivational interviews on treatment adherence and insight levels of patients with schizophrenia: A randomized controlled study.

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The effect of motivational interviews on treatment adherence and insight levels of patients with schizophrenia: A randomized controlled study.

Perspect Psychiatr Care. 2018 Jun 11;:

Authors: Ertem MY, Duman ZÇ

Abstract
PURPOSE: To examine the effect of motivational interview (MI) on treatment adherence and insight of the patients diagnosed with schizophrenia at a hospital in Turkey.
DESIGN AND METHODS: Individuals with schizophrenia, who match with the sample characteristics, were assigned to intervention (20) and control groups (20) according to the randomization schedule. Personal Information Form, Morisky’s Questions-Self-Report Measure of Adherence, and Schedule for Assessing the Three Components of Insight were used.
FINDINGS: Group-wise examinations showed that mean scores of “three component scales of insight” yielded statistically significant difference for the intervention group. Analysis of the Morisky Adherence Scale Mean Scores showed a significant difference for interval mean scores of the intervention group.
PRACTICE IMPLICATIONS: Both the pyschiatric patients and the health institutions can benefit from increased levels of treatment adherence and insight by the adoption of the MI methods starting with a patient’s first registration to a psychiatric outpatient clinic.
IMPLICATIONS FOR NURSING PRACTICE: MI can be included during any of the patient visits to establish treatment collaboration with psychiatric patients at psychiatric facilities, outpatient clinics, and community mental health centers.

PMID: 29888541 [PubMed – as supplied by publisher]

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Identifying clinical net benefit of psychotropic medication use with latent variable techniques: Evidence from Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD).

Identifying clinical net benefit of psychotropic medication use with latent variable techniques: Evidence from Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD).

J Affect Disord. 2018 May 29;238:147-155

Authors: Bareis N, Lu J, Kirkwood CK, Kornstein SG, Wu E, Mezuk B

Abstract
BACKGROUND: Poor medication adherence is common among individuals with Bipolar Disorder (BD). Understanding the sources of heterogeneity in clinical net benefit (CNB) and how it is related to psychotropic medications can provide new insight into ways to improve adherence.
METHODS: Data come from the baseline assessments of the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Latent class analysis identified groups of CNB, and validity of this construct was assessed using the SF-36. Adherence was defined as taking 75% or more of medications as prescribed. Associations between CNB and adherence were tested using multiple logistic regression adjusting for sociodemographic characteristics.
RESULTS: Five classes of CNB were identified: High (24%), Moderately high (12%), Moderate (26%), Moderately low (27%) and Low (12%). Adherence to psychotropic medications did not differ across classes (71% to 75%, χ2 = 3.43, p = 0.488). Medication regimens differed by class: 57% of the High CNB were taking ≤2 medications, whereas 49% of the Low CNB were taking ≥4. CNB classes had good concordance with the SF-36.
LIMITATIONS: Missing data limited measures used to define CNB. Participants’ perceptions of their illness and treatment were not assessed.
CONCLUSIONS: This novel operationalization of CNB has construct validity as indicated by the SF-36. Although CNB and polypharmacy regimens are heterogeneous in this sample, adherence is similar across CNB. Studying adherent individuals, despite suboptimal CNB, may provide novel insights into aspects influencing adherence.

PMID: 29883936 [PubMed – as supplied by publisher]

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Circadian Rhythm in Bipolar Disorder: A review of the literature.

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Circadian Rhythm in Bipolar Disorder: A review of the literature.
Psychiatry Clin Neurosci. 2018 Jun 05;:
Authors: Takaesu Y
Abstract
Sleep disturbances and circadian rhythm dysfunct…

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Reliability and validity of the Medication Adherence Rating Scale in a cohort of patients with schizophrenia from Nigeria.

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Reliability and validity of the Medication Adherence Rating Scale in a cohort of patients with schizophrenia from Nigeria.

Trends Psychiatry Psychother. 2018 May 14;:

Authors: Owie GO, Olotu SO, James BO

Abstract
INTRODUCTION: Assessing adherence in schizophrenia facilitates interventions that optimize outcomes. Adherence rating questionnaires are feasible and non-intrusive; however, no validated measure exists in sub-Saharan Africa. We aimed to assess the psychometric properties of the 10-item Medication Adherence Rating Scale (MARS).
METHODS: This was a cross-sectional study of a cohort of patients with schizophrenia (n=230). A sociodemographic questionnaire, the Mini International Neuropsychiatric Interview (MINI), Positive and Negative Syndrome Scale (PANSS), Scale for the Unawareness of Mental Disorder (SUMD) and the MARS were all administered by an interviewer.
RESULTS: The MARS demonstrated good reliability (Cronbach’s alpha: 0.76). The scale was reducible to a 3-factor construct (1 – medication adherence behavior, 2 – attitude to taking medications, and 3 – negative side effects and attitude to psychotropics), with significant though weak external validity in relation to psychopathology (p<0.001) and insight (p<0.001). The first factor showed good internal consistency (α=0.80), comprising six items that could serve as a reliable proxy measure of adherence in place of the MARS.
CONCLUSION: The MARS demonstrated fair psychometric characteristics in assessing adherence in patients with schizophrenia in this cohort. The scale may be useful in the dimensional assessment of medication adherence for schizophrenia in sub-Saharan African settings.

PMID: 29768528 [PubMed – as supplied by publisher]

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Motives, Offending Behavior, and Gender Differences in Murder Perpetrators With or Without Psychosis.

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Motives, Offending Behavior, and Gender Differences in Murder Perpetrators With or Without Psychosis.
J Interpers Violence. 2018 May 01;:886260518774304
Authors: Hachtel H, Nixon M, Bennett D, Mulle…

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A Cross-sectional Analysis of Patterns and Predictors of Medication Adherence in Bipolar Disorder: Single Center Experience from South India.

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A Cross-sectional Analysis of Patterns and Predictors of Medication Adherence in Bipolar Disorder: Single Center Experience from South India.

Clin Psychopharmacol Neurosci. 2018 May 31;16(2):168-175

Authors: Selvakumar N, Menon V, Kattimani S

Abstract
Objective: Our objective was to determine patterns and predictors of medication adherence in bipolar disorder.
Methods: Between August 2015 and December 2016, we recruited 160 patients with a diagnosis of bipolar disorder as per International Classification of Diseases-10: Clinical Descriptions and Diagnostic Guidelines. The diagnosis was further confirmed by using the MINI International Neuropsychiatric Inventory. All of them were currently in remission (confirmed by standard measures) and on stable dosing of medication for at least a year. Medication adherence was assessed using Tamil validated version of Morisky Medication Adherence Scale. Patients were dichotomized into low adherence (<6) and high adherence (≥6) groups and compared on various socio-demographic and clinical variables.
Results: Majority of the sample (n=97, 60.6%) demonstrated low adherence to treatment regimen. Being employed and having spent greater number of days in hospital were predictive of higher medication adherence (odds ratio [OR] 2.78, 95% confidence interval [CI] 1.019-7.585; and OR 1.02, 95% CI 1.003-1.037, respectively). Fewer number of lifetime depressive episodes and positive drug attitudes demonstrated trend level positive association with high medication adherence.
Conclusion: Non-adherence to prescribed medications is a common problem in bipolar disorder. Interventions targeting vocation, medication focused psychoeducation and promotion of positive drug attitudes are likely to enhance medication adherence in this group.

PMID: 29739130 [PubMed]

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Quetiapine Related Acute Paralytic Ileus in a Bipolar I Disorder Patient with Successful Low Dose Amisulpride Substitution: A Case Report.

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Quetiapine Related Acute Paralytic Ileus in a Bipolar I Disorder Patient with Successful Low Dose Amisulpride Substitution: A Case Report.
Clin Psychopharmacol Neurosci. 2018 May 31;16(2):228-231
Au…

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Cognitive Stimulation Therapy for Dementia: Pilot Studies of Acceptability and Feasibility of Cultural Adaptation for India.

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Cognitive Stimulation Therapy for Dementia: Pilot Studies of Acceptability and Feasibility of Cultural Adaptation for India.
Am J Geriatr Psychiatry. 2017 Sep;25(9):1029-1032
Authors: Raghuraman S,…

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Adherence and economic impact of paliperidone palmitate versus oral atypical antipsychotics in a Medicare population.

Adherence and economic impact of paliperidone palmitate versus oral atypical antipsychotics in a Medicare population.

J Comp Eff Res. 2018 May 03;:

Authors: Joshi K, Muser E, Xu Y, Schwab P, Datar M, Suehs B

Abstract
AIM: To compare adherence, healthcare utilization and costs among real world, Medicare-eligible patients with schizophrenia using long-acting injectable paliperidone palmitate (PP) versus oral atypical antipsychotics. Patients & methods: Historical cohort study used Medicare Advantage claims data. Inverse probability of treatment weighting was applied to adjust for baseline differences. 12-month adherence, healthcare utilization and costs were compared.
RESULTS: Patients using PP were more adherent (proportion of days covered ≥0.8; 48.1 vs 32.6%; p < 0.001), had lower odds of hospitalization (odds ratio [OR]: 0.81; 95% CI: 0.68-0.96) and lower medical costs ($11,095; 95% CI: $10,374-11,867 vs $15,551; 95% CI: $14,584-16,583), but higher pharmacy costs ($14,787; 95% CI: $14,117-15,488 vs $5781; 95% CI: $5530-6043).
CONCLUSION: Compared with patients using oral atypical antipsychotics, PP had lower hospitalizations and medical costs with greater medication adherence accompanied by higher pharmacy costs.

PMID: 29722547 [PubMed – as supplied by publisher]

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Management of complications of ketamine abuse: 10 years’ experience in Hong Kong.

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Management of complications of ketamine abuse: 10 years’ experience in Hong Kong.
Hong Kong Med J. 2018 Apr 06;:
Authors: Hong YL, Yee CH, Tam YH, Wong JH, Lai PT, Ng CF
Abstract
Ket…

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