Examining Factors Associated With Medication Adherence in Youth With Bipolar Disorder.
Mohamed Y Elhosary1, John A Merranko1, Tina R Goldstein1
1UPMC Western Psychiatric Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania.
JAACAP Open
|October 9, 2024
Summary
Poor medication adherence is common in youth with bipolar disorder (BD), with comorbid ADHD being a major factor. Addressing ADHD and patient concerns is key to improving treatment outcomes.
Area of Science:
- Psychiatry
- Neuroscience
- Pediatrics
Background:
- Medication adherence is crucial for managing bipolar disorder (BD) in youth.
- Longitudinal data on adherence challenges in this population is limited.
Purpose of the Study:
- To assess medication adherence in youth with BD from adolescence to young adulthood.
- To identify factors associated with poor medication adherence.
Main Methods:
- Longitudinal analysis of 179 participants (ages 12-36) from the Course and Outcome of Bipolar Youth (COBY) study.
- Medication adherence evaluated over a median of 8 years using a validated questionnaire.
- Concurrent and future predictors of nonadherence analyzed using univariate and multivariate models.
Main Results:
- 51% of participants reported poor adherence in over 50% of follow-ups.
- Comorbid ADHD was the strongest predictor of poor adherence across all age groups.
- Top reported reasons for nonadherence included forgetfulness, negative attitudes, and disrupted routines.
Conclusions:
- Poor medication adherence is a significant issue in youth with BD, strongly linked to comorbid ADHD.
- Treating comorbid ADHD is essential for improving adherence and prognosis.
- Interventions should address patient concerns and support consistent medication intake.
Related Concept Videos
01:24Mania and Antimanic Drugs: Overview
138
Mania, a psychological condition characterized by elevated mood, increased energy, and reduced sleep need, is part of the bipolar disorder cycle. The exact cause of mania isn't entirely known, but it is thought to be a combination of genetic, environmental, and neurological factors. Bipolar disorder involves alternating manic and depressive episodes. Mood stabilizers like lithium, antipsychotics, and anticonvulsants help manage these episodes. Lithium carbonate is particularly effective as...
138
01:28Drug Therapy
39
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
39
01:30Bipolar Disorder
56
Bipolar disorder is a chronic mental health condition marked by significant mood fluctuations, including episodes of mania and depression. Elevated energy levels, heightened mood or irritability, impulsive behavior, reduced sleep needs, rapid speech, racing thoughts, inflated self-esteem, and distractibility characterize mania. Individuals with bipolar disorder often alternate between depressive and manic states, with periods of emotional stability lasting an average of six months to a year.
56
01:30Attention-Deficit/Hyperactivity Disorder
47
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent inattention, hyperactivity, and impulsivity. It affects approximately 5-8% of children globally, with around 60-70% of cases persisting into adulthood. ADHD has significant implications for educational attainment, social interactions, and occupational success.
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....
47
01:26Psychosis: Goals of Pharmacotherapy
109
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
109
01:28Psychosis and Antipsychotic Drugs: Overview
186
The term "psychosis" refers to a spectrum of mental disorders characterized by abnormal thoughts, perceptions, and behaviors. It can manifest as mood disorders, dementia, delirium with psychotic features, substance-induced psychosis with psychotic features, brief psychotic disorder, delusional disorder, schizoaffective disorder, and schizophrenia. Among all these disorders, schizophrenia is the most common psychotic disorder, affecting 1% of the worldwide population. Psychotic...
186