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Conocimiento del tratamiento en esquizofrenia y trastorno esquizoafectivo y su relación con la no adherencia

  • Francisco J Acosta [2] ; Dulcinea Vega [1] ; Pedro Saavedra [1]
    1. [1] Universidad de Las Palmas de Gran Canaria

      Universidad de Las Palmas de Gran Canaria

      Gran Canaria, España

    2. [2] Servicio de Salud Mental. Dirección General de Programas Asistenciales. Servicio Canario de la Salud. Hospital Universitario de Gran Canaria Dr. Negrín. Canarias, España.
  • Localización: Actas españolas de psiquiatría, ISSN 1139-9287, Vol. 51, Nº. 4 (Julio-Agosto), 2023, págs. 157-166
  • Idioma: español
  • Títulos paralelos:
    • Knowledge of the treatment in schizophrenia and schizoaffective disorder and its relationship with nonadherence
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  • Resumen
    • español

      Introducción. El conocimiento del tratamiento ha sido escasamente estudiado en pacientes con psicosis, a pesar de su potencial importancia para la adherencia. Evaluamos la posible asociación entre el conocimiento del tratamiento y la no adherencia, no adherencia no intencional (NANI) y no adherencia intencional (NAI).

      Metodología. Se incluyeron 106 pacientes con diagnóstico de esquizofrenia o trastorno esquizoafectivo que ingresaron consecutivamente. Las evaluaciones se realizaron durante la hospitalización y a los seis meses de seguimiento. Se incluyeron variables sociodemográficas, clínicas, psicopatológicas y relacionadas con el tratamiento. La adherencia se definió como la concurrencia de adherencia al tratamiento antipsicótico y adherencia al seguimiento ambulatorio durante ese periodo de seis meses. Establecimos dos subtipos de no adherencia dependiendo del motivo principal de no adherencia: NANI y NAI.

      Resultados. El 45,3% de los pacientes mostraron un inadecuado conocimiento del tratamiento. Los pacientes adherentes, comparados con los no adherentes, no mostraron diferencias en el conocimiento del tratamiento (mediana 77 vs. 77, respectivamente; p = 0,232). Sin embargo, los pacientes NANI presentaron peor conocimiento del tratamiento comparados con los pacientes adherentes (mediana 62 vs. 77 respectivamente; p < 0,001), mientras que los pacientes NAI presentaron mejor conocimiento del tratamiento comparados con los pacientes adherentes (mediana 86 vs. 77, respectivamente; p = 0,026).

      Conclusión. Un alto porcentaje de los pacientes con esquizofrenia y trastorno esquizoafectivo no tienen un adecuado conocimiento del tratamiento. Además, nuestros resultados sugieren que un inadecuado conocimiento del tratamiento puede contribuir a la no adherencia en pacientes con no adherencia no intencional.

    • English

      Background and objectives. Despite its potential importance for adherence, knowledge of the treatment has been little studied in patients with psychosis. We performed this study to assess the possible association between knowledge of the treatment and nonadherence, unintentional nonadherence (UNA) and intentional nonadherence (INA).

      Methods. We assessed 106 consecutively admitted patients diagnosed with schizophrenia or schizoaffective disorder. Evaluations were carried out during hospitalization and after six-months of follow-up. This included sociodemographic, clinical, psychopathologic variables and those related to treatment. Adherence was interpreted as the concurrence of adherence to antipsychotic treatment and adherence to outpatient follow-up over the course of the six-month period. We established two subtypes according to the main reason for nonadherence: unintentional and intentional nonadherence.

      Results. Inadequate knowledge of the treatment was detected in 45.3% of patients. Adherent patients, as compared to nonadherent patients, showed no difference regarding knowledge of the treatment (median 77 vs. 77, respectively; p = 0.232). Nevertheless, UNA patients showed worse knowledge of the treatment as compared to adherent patients (median 62 vs. 77 respectively; p < 0.001), whereas INA patients showed better knowledge of the treatment as compared to adherent patients (median 86 vs. 77, respectively; p = 0.026).

      Conclusions. A large number of patients with schizophrenia or schizoaffective disorder did not have an appropriate knowledge of their treatment. More importantly, our results suggest that inadequate knowledge of the treatment may contribute to nonadherence in patients with unintentional nonadherence.

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