García Saínza, Alberich Susana, MacDowell Karina S, Martínez-Cengotitabengoa Mónica, López Purificación, Zorrilla Iñaki, Leza Juan Carlos, González-Pinto Ana
Department of Psychiatry, University Hospital of Alava-Santiago, Vitoria, Spain.
Centre for Biomedical Research Network on Mental Health (CIBERSAM), Madrid, Spain.
Front Psychiatry. 2019 Mar 26;10:162. doi: 10.3389/fpsyt.2019.00162. eCollection 2019.
Poor adherence is a major problem in patients with manic episodes that impairs functionality and has unknown effects on oxidative stress. The objective of this study was to analyze the relationship between adherence to medication, severity of symptoms and oxidative stress in a sample of patients with a first episode of mania. A longitudinal, 6-month study was performed in 60 patients, who were classified as adherent and non-adherent to medication (mainly antipsychotics). Blood levels of oxidative stress parameters and expression of the antioxidant nuclear transcription factor NRF2 in mononuclear cells of peripheral blood were assessed at baseline and at the end of follow-up. In addition, clinical symptoms and functioning were evaluated. Linear multivariate regression was used to determine the relationship between adherence, oxidative stress, and clinical symptoms. Finally, 44 patients completed follow-up. The results of this study showed that at 6-month follow-up, adherence was significantly associated with better functioning and reduced clinical symptoms. Additionally, more severe symptoms were associated with increased levels of oxidative stress and antioxidant parameters. At study completion, non-adherents exhibited greater levels of antioxidants than adherent patients. In conclusion, poor adherence to medication is associated with a poorer prognosis in the medium term and causes increased antioxidant response.
依从性差是躁狂发作患者的一个主要问题，它会损害功能，并且对氧化应激的影响尚不清楚。本研究的目的是分析首次躁狂发作患者样本中药物依从性、症状严重程度和氧化应激之间的关系。对60名患者进行了一项为期6个月的纵向研究，这些患者被分为药物依从组和非依从组（主要是抗精神病药物）。在基线和随访结束时评估了外周血单核细胞中氧化应激参数的血液水平以及抗氧化核转录因子NRF2的表达。此外，还评估了临床症状和功能。采用线性多变量回归来确定依从性、氧化应激和临床症状之间的关系。最后，44名患者完成了随访。本研究结果表明，在6个月的随访中，依从性与更好的功能和减轻的临床症状显著相关。此外，更严重的症状与氧化应激水平和抗氧化参数的增加有关。在研究结束时，非依从患者的抗氧化剂水平高于依从患者。总之，药物依从性差与中期预后较差相关，并导致抗氧化反应增加。
