Factors Associated With Medication Adherence Among Psychiatric Outpatients at Substance Abuse Risk.

Factors associated with medication adherence among psychiatric outpatients at substance abuse risk.

Filed under: Depression Treatment

Open Addict J. 2011 Nov 11; 4: 58-64
Magura S, Rosenblum A, Fong C

Substance misuse is usually associated with poorer psychiatric medication adherence among psychiatric patients. Identifying predictors of medication adherence among patients with dual psychiatric and substance misuse problems is important because poor adherence is associated with relapse and re-hospitalization. The subjects were patients newly admitted to a psychiatric outpatient program who were prescribed psychiatric medication from different providers during the six months prior to admission; all also had substance misuse histories (N=131). Confidential research interviews were conducted that included a modified Medication Adherence Rating Scale (MARS) and drug toxicologies. Age (mean): 39 y; male 61%; Black 41%; Hispanic 38%; White 21%; completed high school/GED 41%; DSM-IV diagnoses: major depression 26%, schizoaffective 21%, bipolar 16%, schizophrenia 13%, other 24%; positive drug toxiology 55%. Potentially malleable factors correlated with lower adherence were: lower friends’ support for drug/alcohol abstinence, more recovery-promoting behaviors, lower satisfaction with medication, more medication side effects, lower self-efficacy for drug avoidance, and lower social support for recovery. In multivariate regression analysis, only the last three factors remained as significant predictors of adherence. Low adherence is not attributable to simply forgetting to take medication. Strengthening adherence should also include better education about side effects and the importance of adherence to sustain the benefits of medication. Psychiatrists and other medical providers should also be encouraged to address patients’ adherence strategies, since the time devoted to addressing that during treatment may prevent serious adverse events such as relapse to substance abuse, treatment drop-out and re-hospitalization.
HubMed – depression

Father’s Incarceration and Youth Delinquency and Depression: Examining Differences by Race and Ethnicity.

Filed under: Depression Treatment

J Res Adolesc. 2012 Dec 1; 22(4): 597-603
Swisher RR, Roettger ME

This paper examines associations between biological father’s incarceration and internalizing and externalizing outcomes of depression and serious delinquency, across White, Black, and Hispanic subsamples of youth in the National Longitudinal Study of Adolescent Health. Among respondents whose father was first incarcerated during childhood or adolescence, father’s incarceration is found to be associated with increased depression and delinquency. On the whole, results indicate that associations between father’s incarceration and depression and delinquency do not vary by race and ethnicity or gender. One exception is among Hispanic respondents, for whom having a biological father incarcerated is associated with an even higher propensity of delinquency than among White and Black respondents with incarcerated fathers.
HubMed – depression

Quality of life in a cohort of familial hypercholesterolemia patients from the south of Europe.

Filed under: Depression Treatment

Eur J Public Health. 2012 Dec 22;
Mata N, Alonso R, Banegas JR, Zambón D, Brea A, Mata P

OBJECTIVES: This study describes health-related quality of life (HRQL) in a large sample of molecularly defined familial hypercholesterolemia (FH) patients compared with unaffected relatives. Study design and setting: Cross-sectional study of cases recruited in the Spanish FH cohort study. A total of 1947 subjects ?18 years were included-1321 FH and 626 unaffected relatives. HRQL was assessed by 12-Item Short-Form Health Survey questionnaire. Main outcomes were as follows: Self-perceived health, physical summary component, mental summary component and their independent covariates. RESULTS: Mean age was 45.3 years in FH subjects and 40.4 years in control subjects (P < 0.001). Cardiovascular disease (CVD) was present in 14.1% of FH patients and in 3.2% of control subjects (P < 0.001). Frequency of optimal self-perceived health, mean physical summary component and mental summary component of FH patients (81.5%, 52.1 and 51.1, respectively), were similar to those of control subjects (83.1%, 53.1 and 51.1, respectively). Factors independently associated with a worse HRQL in FH patients were as follows: CVD, female gender, older age, depression, obesity, lower educational level, lower physical activity and xanthomas. CONCLUSIONS: HRQL of FH patients was similar to control subjects, despite their higher burden of premature CVD. The most important factors with a negative impact in quality of life in FH are CVD, female gender and older age. HubMed – depression

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