Predicting medication non-adherence in severe affective disorders.

Objective This study explored the utility of the Health Belief Models (HBM) in explaining medication adherence in subjects with severe affective disorders. Method Well established measuring instruments, with confirmed reliability and validity, were used to assess each component of two HBMs and adherence with mood stabilising medication in 104 subjects with bipolar (n=82), unipolar (n=18) or schizo-affective (n=4) disorders. Results Highly adherent and partially adherent subjects differed significantly in the stability of the level and the overall serum level of drug acheived. Subject's beliefs about themselves and their illness and their control over the disorder were more important than side-effects in predicting medication adherence. There were marked differences in the primary reasons for non-adherence identified by patients and their clinicians. Conclusion Although the study has a number of methodological limitations, the results suggest that clinical assessment of components of HBMs may improve the detection of patients at risk of non-adherence with mood stabilising medication.