Determinants of adherence to treatment in first-episode psychosis: a comprehensive review

摘要: Objective: To conduct a comprehensive review of current evidence on factors for nonadherence to treatment in individuals with first-episode psychosis (FEP). Methods: MEDLINE, LILACS, PsycINFO, and SciELO databases were searched the keywords first episode psychosis, factor, adherence, nonadherence, engagement, disengagement, compliance, intervention. References selected studies consulted relevant articles. Results: A total 157 articles screened, which 33 retained full review. The related were: a) patient-related (e.g., lower education level, persistent substance use, forensic history, unemployment, history physical abuse); b) environment-related no family involved treatment, social adjustment difficulties); c) medication-related rapid remission negative symptoms when starting therapeutic alliance); d) illness-related more positive symptoms, relapses). Treatment that improve adherence include good alliance voluntary admission hospitalization occurs. Conclusion: results this suggest FEP is multifactorial. Many these are modifiable can be specifically targeted early intervention programs. Very few have assessed strategies raise FEP.