Original ArticlesThe Relationship Between Medication Attitudes and Medication Adherence Behavior in Adults With Bipolar DisorderLevin, Jennifer B. PhD*,†; Aebi, Michelle E. MA*; Howland, Molly MD*; Barboza, Marina MA*,‡; Eskew, Logan MA*,‡; Tatsuoka, Curtis PhD†,§; Cassidy, Kristin A. MA*; Sajatovic, Martha MD*,†Author Information *Department of Psychiatry, Case Western Reserve University School of Medicine †Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center ‡Department of Psychology, Cleveland State University §Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio. Send reprint requests to Jennifer B. Levin, PhD, Department of Psychiatry, University Hospitals Cleveland Medical Center, 10524 Euclid Ave, Cleveland, OH 44106. E-mail: Jennifer.firstname.lastname@example.org. Online date: January 13, 2020 The Journal of Nervous and Mental Disease: February 2020 - Volume 208 - Issue 2 - p 87-93 doi: 10.1097/NMD.0000000000001083 Buy Metrics Abstract The relationship between medication attitudes and adherence as well as reliable measures of medication attitudes need further study. This study examined the psychometric properties of the Attitudes Toward Mood Stabilizers Questionnaire (AMSQ) in bipolar participants and the relationship between medication attitudes and adherence, measured by the self-reported Tablets Routine Questionnaire (TRQ). Inclusion criteria included mood stabilizer treatment and 20% or more medication nonadherence. Measures were given pretreatment and posttreatment. Average age was 47 years; majority were female (69%), African American (67%), and unmarried (53%). AMSQ's test-retest reliability was ρ = 0.73 (p < 0.001). AMSQ correlated with TRQ (rs = 0.20, p < 0.01) at baseline. Factor analysis identified three factors: positive/favorable attitudes, negative/critical attitudes, and unintentional nonadherence. Change in AMSQ across time correlated with change in TRQ. The AMSQ is valid psychometrically and is sensitive to change. Medication attitudes are related to adherence behavior. Interventions should include targeting specific domains of medication attitudes, such as illness knowledge. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.