Medication adherence in first‐episode psychosis patients in Singapore

Tan, C.S.; Abdin, Edimansyah; Liang, Wilfred; Poon, Lye Yin; Poon, Ngar Yee; Verma, Swapna

doi:10.1111/eip.12559

Cited by 17 publications

(12 citation statements)

References 55 publications

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“…Nonadherence to treatment leads to frequent hospitalizations and poor prognosis, which increases not only the burden of care on the family, but also the individual's level of burnout, disability, and the likelihood of suicide or harm to others (Tan et al, 2019). In addition, criminal activity among patients who do not adhere to treatment reinforces public stereotypes about these individuals, leading to a vicious cycle.…”

Section: Introductionmentioning

confidence: 99%

Validity and reliability of the internalized stigma of Mental Illness Scale–Adolescent Form

Dіkeç

Bilaç

Uzunoğlu³

et al. 2020

Child Adoles Psych Nursing

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Purpose The goal of this study was to assess the validity and reliability of the Turkish version of the Internalized Stigma of Mental Illness Scale–Adolescent Form (ISMI‐AF). Methods A total of 145 adolescents (12–18 years of age) who were diagnosed with at least one mental disorder according to DSM‐5‐TR participated in the study. Data were collected at a mental health hospital between October 2017 and 2019 using a sociodemographic information form, the ISMI‐AF, and Beliefs towards Mental Illness (BMI) Scale. Reliability (Cronbach's alpha, Split–Half, Spearman–Brown, Hotelling T2 test) and validity analyses of the ISMI‐AF were performed. SPSS 26.0 and LISREL 8.80 software were used for statistical analyses. Results The Cronbach's alpha coefficient for total score was .88, Split–Half score was .84, and the Spearman–Brown factor score was .85. Confirmatory factor analysis showed that the scale confirmed to the five‐factor structure in adolescents, but factor loadings and reliability coefficients were low in the “stigma resistance” subscale. There was a positive and weak correlation between ISMI‐AF and BMI (r = .37, p = .00). Conclusion The ISMI‐AF is a valid and reliable measurement tool that can be used in adolescents. This scale can help psychiatric nurses who work in this field identify and address internalized stigma, which is one of the key factors affecting adherence to treatment, especially in adolescents.

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Section: Introductionmentioning

confidence: 99%

Validity and reliability of the internalized stigma of Mental Illness Scale–Adolescent Form

Dіkeç

Bilaç

Uzunoğlu³

et al. 2020

Child Adoles Psych Nursing

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“…A lack of treatment adherence is associated with poor clinical and functional outcomes. Moreover, a high number of FEP patients are non-adherent to treatment at 12-month follow-up, which increases the risk of relapse and rehospitalisations [ 2 , 11 , 54 , 55 ]. Our results, according to other studies, revealed that psychoeducational intervention could be crucial for improving adherence to medication and illness course, and that clinical outcomes of patients not only depend on initial treatment but also on continued adherence to treatment.…”

Section: Discussionmentioning

confidence: 99%

A Multicentre, Randomised, Controlled Trial of a Combined Clinical Treatment for First-Episode Psychosis

González-Ortega

Vega

Echeburúa

et al. 2021

IJERPH

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Introduction: There is evidence that early intervention contributes to improving the prognosis and course of first-episode psychosis (FEP). However, further randomised treatment clinical trials are needed. Objectives: The aim of this study was to compare the efficacy of a combined clinical treatment involving Cognitive Behavioural Therapy (CBT) as an adjunctive to treatment-as-usual (TAU) (CBT+TAU) versus TAU alone for FEP. Patients and methods: In this multicentre, single-blind, randomised controlled trial, 177 participants were randomly allocated to either CBT+TAU or TAU. The primary outcome was post-treatment patient functioning. Results: The CBT+TAU group showed a greater improvement in functioning, which was measured using the Global Assessment Functioning (GAF) and Functioning Assessment Short Test (FAST), compared to the TAU group post-treatment. The CBT+TAU participants exhibited a greater decline in depressive, negative, and general psychotic symptoms; a better awareness of the disease and treatment adherence; and a greater increase in brain-derived neurotrophic factor levels than TAU participants. Conclusions: Early intervention based on a combined clinical treatment involving CBT as an adjunctive to standard treatment may improve clinical and functional outcomes in FEP.

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“…The authors found a significant association between aggression and duration of untreated illness. The multi-ethnic population, low prevalence of alcohol and other substance use disorders ( 30 , 31 ), relatively low treatment gap ( 32 ) and high medication compliance ( 33 ), emphasize the need for local data in Singapore. Thus, the current study aims to (i) examine underlying factor structure of the Buss-Perry Aggression Questionnaire (BPAQ) and (ii) explore the socio-demographic and clinical associations (symptom severity, drug and alcohol use) of aggression as assessed by BPAQ among patients with schizophrenia and related psychoses in a multi-ethnic Asian population.…”

Section: Introductionmentioning

confidence: 99%

Aggression Amongst Outpatients With Schizophrenia and Related Psychoses in a Tertiary Mental Health Institution

et al. 2022

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Aims: Aggression is defined as “any behavior intended to cause physical, emotional, or psychological harm to another.” The aims of the current study were to (i) examine underlying factor structure of the Buss-Perry Aggression Questionnaire (BPAQ) and (ii) explore socio-demographic and clinical correlates (symptom severity, substance use and alcohol use) among patients with schizophrenia and related psychoses in a multi-ethnic Asian population.Methods: Data collected from 397 participants who were seeking outpatient treatment for schizophrenia and related psychoses at a tertiary psychiatric hospital were included in the analyses. BPAQ, a 29-item, four-factor instrument that measures physical aggression, verbal aggression, anger and hostility was used to assess aggression. Data on socio-demographic variables, age of onset of illness, drug use, alcohol use and symptom severity were also collected. Confirmatory factor analysis (CFA) was performed to establish the underlying factor structure of the BPAQ. Multiple regression analyses were utilized to examine socio-demographic and clinical correlates of the BPAQ factors.Results: The mean age of the participants was 36.2 years (SD = 10.9, range: 21–65). Factor structure obtained from the CFA indicated that a higher order four-factor solution had an acceptable fit to the observed data (WLSMV χ2 = 1,025.35, df = 320, RMSEA = 0.07, CFI = 0.94, TLI = 0.93, SRMR = 0.05). Females had lower physical aggression and hostility scores as compared to males. Those with lower education had higher physical aggression scores as compared to those with higher education. Participants who received a diagnosis after the age of 30 years had higher physical aggression and anger scores as compared to those who received a diagnosis at or before 20 years of age. Symptom severity was positively associated with higher BPAQ scores.Conclusion: The study findings demonstrated high internal consistency and applicable measurement factor structure of BPAQ in this study sample, making it an appropriate questionnaire for assessing aggressive behavior in this population. We also identified socio-demographic and clinical factors that were associated with aggression in patients with schizophrenia and related psychoses.

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Medication adherence in first‐episode psychosis patients in Singapore

Abstract: Medication adherence is prevalent in FEP and associated with a variety of factors. This study supports the use of culturally appropriate interventions in addressing barriers to adherence. Further studies would need to be done to address specific factors affecting adherence outcomes.

Cited by 17 publications

References 55 publications

Validity and reliability of the internalized stigma of Mental Illness Scale–Adolescent Form

Validity and reliability of the internalized stigma of Mental Illness Scale–Adolescent Form

A Multicentre, Randomised, Controlled Trial of a Combined Clinical Treatment for First-Episode Psychosis

Aggression Amongst Outpatients With Schizophrenia and Related Psychoses in a Tertiary Mental Health Institution

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