Yen Cheng-Fang, Chen Cheng-Sheng, Ko Chih-Hung, Yeh Ming-Li, Yang Shang-Ju, Yen Ju-Yu, Huang Chi-Feng, Wu Chia-Chen
Department of Psychiatry, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan.
Psychiatry Clin Neurosci. 2005 Aug;59(4):403-9. doi: 10.1111/j.1440-1819.2005.01392.x.
The aim of the present study was to explore the associations between insight and medication adherence at index interview and at 1-year follow-up interview in bipolar and schizophrenic outpatients. The Schedule for Assessment of Insight (SAI) and its expanded version (SAI-E) were used to provide a baseline insight score for 65 bipolar subjects and 74 schizophrenic subjects considered to be in remission or to have minimal psychopathology. Medication adherence of subjects was assessed at index interview and at 1-year follow-up interview, and the association between insight and medication adherence was analyzed cross-sectionally and prospectively. The results of the analysis reveal that in bipolar subjects, the index SAI scores for insight into treatment, mental-health status and psychotic experiences, and total SAI-E were positively correlated with medication adherence at both index and 1-year follow-up interviews. However, in schizophrenic subjects, insight into treatment and total SAI-E correlated positively with medication adherence at index interview but not at 1-year follow-up interview. Medication adherence at index interview could predict medication adherence 1 year later in both bipolar and schizophrenic subjects. These results indicate that the predictive value of insight for medication adherence differs between bipolar and schizophrenic patients, and building insight is an important step for establishing medication adherence in bipolar patients.
本研究的目的是探讨双相情感障碍和精神分裂症门诊患者在首次访谈及1年随访访谈时领悟力与药物依从性之间的关联。使用领悟力评估量表（SAI）及其扩展版（SAI-E），为65名双相情感障碍患者和74名精神分裂症患者提供基线领悟力评分，这些患者被认为处于缓解期或精神病理学症状轻微。在首次访谈及1年随访访谈时评估患者的药物依从性，并对领悟力与药物依从性之间的关联进行横断面分析和前瞻性分析。分析结果显示，在双相情感障碍患者中，治疗领悟力、心理健康状况和精神病体验的首次SAI评分以及SAI-E总分，在首次访谈和1年随访访谈时均与药物依从性呈正相关。然而，在精神分裂症患者中，治疗领悟力和SAI-E总分在首次访谈时与药物依从性呈正相关，但在1年随访访谈时并非如此。首次访谈时的药物依从性可预测双相情感障碍和精神分裂症患者1年后的药物依从性。这些结果表明，领悟力对药物依从性的预测价值在双相情感障碍和精神分裂症患者中有所不同，培养领悟力是双相情感障碍患者建立药物依从性的重要一步。
