Raoul Belzeaux1, Laurent Boyer2, Pascale Mazzola-Pomietto3, Pierre Michel2, Nadia Correard4, Valerie Aubin5, Frank Bellivier6, Thierry Bougerol7, Emilie Olie8, Philippe Courtet8, Bruno Etain9, Sébastien Gard10, Jean-Pierre Kahn11, Christine Passerieux12, Marion Leboyer9, Chantal Henry9, Jean-Michel Azorin13. 1. Pôle de psychiatrie, Hôpital Sainte Marguerite, Assistance Publique Hôpitaux de Marseille, France; Aix-Marseille Université, CNRS, CRN2M UMR 7286, 13344 cedex 15, Marseille, France; Fondation FondaMental, Créteil, France. Electronic address: raoul.belzeaux@ap-hm.fr. 2. EA 3279-Self-perceived Health Assessment Research Unit, School of Medicine, Timone University, Marseille, France. 3. Aix-Marseille Université, CNRS, INT UMR 7289, 13385 cedex 15, Marseille, France. 4. Pôle de psychiatrie, Hôpital Sainte Marguerite, Assistance Publique Hôpitaux de Marseille, France; Fondation FondaMental, Créteil, France. 5. Fondation FondaMental, Créteil, France; Service de psychiatrie, Centre hospitalier Princesse-Grace, Avenue Pasteur, Monaco. 6. Fondation FondaMental, Créteil, France; AP-HP, GH Saint-Louis-Lariboisière-Fernand Widal, Pôle Neurosciences, Paris, France. 7. Fondation FondaMental, Créteil, France; Clinique Universitaire de Psychiatrie, CHU de Grenoble, Grenoble, France. 8. Fondation FondaMental, Créteil, France; Département d'Urgence et Post Urgence Psychiatrique, CHRU Montpellier, INSERM U1061, Université Montpellier 1, Montpellier, France. 9. Fondation FondaMental, Créteil, France; Inserm, U955, Equipe de psychiatrie génétique et Université Paris Est, Faculté de médecine et AP-HP, Hôpitaux Universitaires Henri Mondor, Pôle de psychiatrie, Créteil 94000, France. 10. Fondation FondaMental, Créteil, France; Hôpital Charles Perrens, Centre Expert Trouble Bipolaire, Service de psychiatrie adulte, Pôle 3-4-7, Bordeaux, France. 11. Fondation FondaMental, Créteil, France; Service de Psychiatrie et Psychologie Clinique, CHU de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy, France; Université de Lorraine, France. 12. Fondation FondaMental, Créteil, France; Université de Versailles Saint-Quentin, Centre Hospitalier de Versailles, Service de Psychiatrie Adulte, Le Chesnay, France. 13. Pôle de psychiatrie, Hôpital Sainte Marguerite, Assistance Publique Hôpitaux de Marseille, France; Fondation FondaMental, Créteil, France; EA 3279-Self-perceived Health Assessment Research Unit, School of Medicine, Timone University, Marseille, France.
Abstract
BACKGROUND: Adherence to medication is a major issue in bipolar disorder. Non-planning impulsivity, defined as a lack of future orientation, has been demonstrated to be the main impulsivity domain altered during euthymia in bipolar disorder patients. It was associated with comorbidities. METHODS: To investigate relationship between adherence to medication and non-planning impulsivity, we included 260 euthymic bipolar patients. Adherence to medication was evaluated by Medication Adherence Rating Scale and non-planning impulsivity by Barrat Impulsiveness Scale. Univariate analyses and linear regression were used. We conducted also a path analysis to examine whether non-planning impulsivity had direct or indirect effect on adherence, mediated by comorbidities. RESULTS: Adherence to medication was correlated with non-planning impulsivity, even after controlling for potential confounding factors in linear regression analysis (Beta standardized coefficient = 0.156; p = 0.015). Path analysis demonstrated only a direct effect of non-planning impulsivity on adherence to medication, and none indirect effect via substance use disorders and anxiety disorders. LIMITATIONS: Our study is limited by its cross-sectional design and adherence to medication was assessed only by self-questionnaire. CONCLUSIONS: Higher non-planning impulsivity is associated with low medication adherence, without an indirect effect via comorbidities.
BACKGROUND: Adherence to medication is a major issue in bipolar disorder. Non-planning impulsivity, defined as a lack of future orientation, has been demonstrated to be the main impulsivity domain altered during euthymia in bipolar disorderpatients. It was associated with comorbidities. METHODS: To investigate relationship between adherence to medication and non-planning impulsivity, we included 260 euthymic bipolarpatients. Adherence to medication was evaluated by Medication Adherence Rating Scale and non-planning impulsivity by Barrat Impulsiveness Scale. Univariate analyses and linear regression were used. We conducted also a path analysis to examine whether non-planning impulsivity had direct or indirect effect on adherence, mediated by comorbidities. RESULTS: Adherence to medication was correlated with non-planning impulsivity, even after controlling for potential confounding factors in linear regression analysis (Beta standardized coefficient = 0.156; p = 0.015). Path analysis demonstrated only a direct effect of non-planning impulsivity on adherence to medication, and none indirect effect via substance use disorders and anxiety disorders. LIMITATIONS: Our study is limited by its cross-sectional design and adherence to medication was assessed only by self-questionnaire. CONCLUSIONS: Higher non-planning impulsivity is associated with low medication adherence, without an indirect effect via comorbidities.
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