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Objective: Treatment compliance among psychiatric patients is related to disease outcomes. How to assess patient compliance remains a concern. Here, we established a predictive model for medication compliance in patients with psychotic disorders to provide a reference for early intervention in treatment non-compliance behaviour.
Design: Clinical information for 451 patients with psychotic disorders was downloaded from the Dryad database. The Least Absolute Shrinkage and Selection Operator regression and logistic regression were used to establish the model. Bootstrap resampling (1000 iterations) was used for internal validation and a nomogram was drawn to predict medication compliance. The consistency index, Brier score, receiver operating characteristic curve and decision curve were used for model evaluation.
Setting: 35 Italian Community Psychiatric Services.
Participants: 451 patients prescribed with any long-acting intramuscular (LAI) antipsychotic were consecutively recruited, and assessed after 6 months and 12 months, from December 2015 to May 2017.
Results: 432 patients with psychotic disorders were included for model construction; among these, the compliance rate was 61.3%. The Drug Attitude Inventory-10 (DAI-10) and Brief Psychiatric Rating Scale (BPRS) scores, multiple hospitalisations in 1 year and a history of long-acting injectables were found to be independent risk factors for treatment noncompliance (all p<0.01). The concordance statistic of the nomogram was 0.709 (95% CI 0.652 to 0.766), the Brier index was 0.215 and the area under the ROC curve was 0.716 (95% CI 0.669 to 0.763); decision curve analysis showed that applying this model between the threshold probabilities of 44% and 63% improved the net clinical benefit.
Conclusion: A low DAI-10 score, a high BPRS score, multiple hospitalisations in 1 year and the previous use of long-acting injectable drugs were independent risk factors for medication noncompliance in patients with psychotic disorders. Our nomogram for predicting treatment adherence behaviour in psychiatric patients exhibited good sensitivity and specificity.
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http://dx.doi.org/10.1136/bmjopen-2024-087312 | DOI Listing |
Front Psychiatry
December 2024
Department of Psychiatry, The Third People's Hospital of Ganzhou City, Ganzhou, Jiangxi, China.
Introduction: Depression is the most common mental illness among older adults, with substantial and persistent mood depression as the main clinical feature, which is unfavorable for improvement. The clinical manifestations can range from melancholy to grief or even numbness. Approximately one-third of older adult patients exhibit physical discomfort as the first symptom; dysgeusia as the first symptom, is very rare in clinical practice.
View Article and Find Full Text PDFTransl Psychiatry
December 2024
West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
Depression is a heterogeneous and complex psychological syndrome with highly variable manifestations, which poses difficulties for treatment and prognosis. Depression patients are prone to developing various comorbidities, which stem from different pathophysiological mechanisms, remaining largely understudied. The current study focused on identifying comorbidity-specific phenotypes, and whether these clustered phenotypes are associated with different treatment patterns, clinical manifestations, physiological characteristics, and prognosis.
View Article and Find Full Text PDFBrain
December 2024
Neuroimmunology Program, Fundació Clínic per la Recerca Biomèdica - Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona 08036, Spain.
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a disorder mediated by autoantibodies against the GluN1 subunit of NMDAR. It occurs with severe neuropsychiatric symptoms that often improve with immunotherapy. Clinical studies and animal models based on patients' antibody transfer or NMDAR immunization suggest that the autoantibodies play a major pathogenic role.
View Article and Find Full Text PDFEur Neuropsychopharmacol
December 2024
Barcelona Clinic Schizophrenia Unit, Institute of Neurosciences, Hospital Clinic, Barcelona, Spain; Institut d'Investigacions Mèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic, Barcelona, Spain; Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain. Electronic address:
Emerging evidence suggests that retinal structural alterations are present in schizophrenia spectrum disorders (SSD), potentially reflecting broader neurodevelopmental and neurodegenerative processes. This cross-sectional study investigates retinal thickness and its clinical correlations in a sample of early-course SSD patients compared to healthy controls (HCs). One hundred-two eyes from 26 SSD cases and 25 age- and sex-matched HCs were included.
View Article and Find Full Text PDFInt J Clin Health Psychol
December 2024
Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
Background: Previous research has found that compulsions in obsessive-compulsive disorder (OCD) are associated with an imbalance between goal-directed and habitual responses. However, the cognitive mechanisms underlying how goal-directed and habitual behaviors are learned, and how these learning deficits affect the response process, remain unclear. The present study aimed to investigate these cognitive mechanisms and examine how they were involved in the mechanism of compulsions.
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