Original ArticlesIllness Insight and Medication Adherence Among Patients With Bipolar DisorderGutiérrez-Rojas, Luis MD*,†,‡; Martínez-Ortega, José María MD*,†; Pérez-Costillas, Lucía MD§,∥; Jiménez-Fernández, Sara MD†,¶; Carretero, María Dolores MD*; Gurpegui, Manuel MD*,†Author Information *Department of Psychiatry †CTS-549 Research Group, Institute of Neurosciences, University of Granada ‡Psychiatry Service, San Cecilio University Hospital, Granada §Psychiatry Service, Malaga Regional University Hospital ∥Department of Psychiatry, University of Malaga, Malaga ¶Child and Adolescent Mental Health Service, Jaén University Medical Center, Jaén, Spain. Send reprint requests to Luis Gutiérrez-Rojas, MD, Department of Psychiatry, Facultad de Medicina–Torre A, Planta 9, E-18071 Granada, Spain. E-mail: firstname.lastname@example.org. Author contributions: L. G. R. participated in the design of the study, collected the data, and participated in the statistical analysis, the interpretation of the data, and the drafting of the article; he approved the final version of the manuscript. J. M. M. O., L. P. C., S. J. F., and M. D. C. participated in the statistical analysis, the interpretation of the data, and the drafting of the article; they approved the final version of the manuscript. M. G. participated in the design of the study, the statistical analysis, the interpretation of the data, and the drafting of the article; he approved the final version of the manuscript. The Journal of Nervous and Mental Disease: June 2020 - Volume 208 - Issue 6 - p 481-487 doi: 10.1097/NMD.0000000000001151 Buy Metrics Abstract The aim of this study was to investigate the factors associated with illness insight and medication adherence in bipolar disorder (BD). This is a cross-sectional study (with a retrospective evaluation of longitudinal variables) and a secondary analysis of a BD database. The insight of 108 outpatients (age, 48.2 ± 14.1 years, 69% women, 33% euthymic) was measured with three items of the Association of Methodology and Documentation in Psychiatry scale. Their adherence was assessed through patients' and caregivers' reports, plus serum levels. We performed multivariate logistic regression analyses. Full insight was independently and directly associated with adherence, a social support score, and depressive symptoms and inversely associated with intensity of manic symptoms, problems ever with alcohol, and age at onset of the first symptoms. Medication adherence was independently and directly associated with insight, being married, and having had a psychiatric hospitalization and inversely with having suffered a high number of depressive episodes, intensity of manic symptoms, and heavy tobacco smoking. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.