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A Reexamination of Nonpsychiatric Medication Adherence in Individuals With Bipolar Disorder and Medical Comorbidities

Levin, Jennifer B. PhD; Krivenko, Anna BS; Bukach, Ashley MA; Tatsuoka, Curtis PhD; Cassidy, Kristin A. MA; Sajatovic, Martha MD

Journal of Nervous & Mental Disease: March 2017 - Volume 205 - Issue 3 - p 182–187
doi: 10.1097/NMD.0000000000000544
Original Articles

Abstract: Individuals with bipolar disorder (BD) have high rates of nonadherence, medical illness, and premature mortality. This analysis reexamined correlates of poor adherence to nonpsychiatric medication in 73 patients with BD and medical comorbidities. The majority was female (74%) and African American (77%) with mean age of 48.08 (SD, 8.04) years, mean BD duration of 28.67 (SD, 10.24) years, mean years of education of 12.01 (SD, 1.87), and mean proportion of days with missed doses in past week of 43.25 (SD, 31.14). Sex, age, education, race, and living alone did not correlate with adherence. More BD medications and more severe psychiatric symptoms correlated with worse adherence. Specifically, poor adherence correlated with the retardation and vegetative factors of Montgomery-Åsberg Depression Rating Scale and affect factor of the Brief Psychiatric Rating Scale. Among poorly adherent patients with BD and medical comorbidities, the number of BD medications, tension/anxiety, and somatic symptoms of depression related to worse nonpsychiatric medication adherence.

*Department of Psychiatry, Case Western Reserve University School of Medicine and University Hospitals Case Medical Center; †Neurological & Behavioral Outcomes Center, University Hospitals Case Medical Center; and ‡Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH.

Send reprint requests to Jennifer B. Levin, PhD, Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, 10524 Euclid Ave, Cleveland, OH 44106. E-mail: jennifer.levin@uhhospitals.org.

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