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Senner F, Hiendl L, Bengesser S, Adorjan K, Anghelescu IG, Baune BT, Budde M, Dannlowski U, Dietrich DE, Falkai P, Fallgatter AJ, Hasan A, Heilbronner M, Jäger M, Juckel G, Kalman JL, Konrad C, Kohshour MO, Papiol S, Reich-Erkelenz D, Reimer J, Schaupp SK, Schmauß M, Senner S, Spitzer C, Vogl T, Zimmermann J, Heilbronner U, Schulte EC, Schulze TG, Reininghaus EZ, Kirchner SK, Dalkner N. Medication adherence and cognitive performance in schizophrenia-spectrum and bipolar disorder: results from the PsyCourse Study. Transl Psychiatry 2023; 13:99. [PMID: 36966169 PMCID: PMC10039892 DOI: 10.1038/s41398-023-02373-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 02/08/2023] [Accepted: 02/16/2023] [Indexed: 03/27/2023] Open
Abstract
Existing guidelines recommend psychopharmacological treatment for the management of schizophrenia and bipolar disorder as part of holistic treatment concepts. About half of the patients do not take their medication regularly, although treatment adherence can prevent exacerbations and re-hospitalizations. To date, the relationship between medication adherence and cognitive performance is understudied. Therefore, this study investigated the relationship between medication adherence and cognitive performance by analyzing the data of 862 participants with schizophrenia-spectrum and bipolar disorders (mean [SD] age, 41.9 [12.48] years; 44.8% female) from a multicenter study (PsyCourse Study). Z-scores for three cognitive domains were calculated, global functioning was measured with the Global Assessment of Functioning Scale, and adherence was assessed by a self-rating questionnaire. We evaluated four multiple linear regression models and built three clusters with hierarchical cluster analyses. Higher adherence behavior (p < 0.001) was associated with better global functioning but showed no impact on the cognitive domains learning and memory, executive function, and psychomotor speed. The hierarchical cluster analysis resulted in three clusters with different cognitive performances, but patients in all clusters showed similar adherence behavior. The study identified cognitive subgroups independent of diagnoses, but no differences were found in the adherence behavior of the patients in these new clusters. In summary, medication adherence was associated with global but not cognitive functioning in patients with schizophrenia-spectrum and bipolar disorders. In both diagnostic groups, cognitive function might be influenced by various factors but not medication adherence.
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Affiliation(s)
- Fanny Senner
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, 80336, Germany
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, 80336, Germany
| | - Lena Hiendl
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Neurobiology and Anthropometrics in Bipolar Affective Disorder, Medical University of Graz, Graz, 8036, Austria
| | - Susanne Bengesser
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Neurobiology and Anthropometrics in Bipolar Affective Disorder, Medical University of Graz, Graz, 8036, Austria.
| | - Kristina Adorjan
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, 80336, Germany
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, 80336, Germany
| | - Ion-George Anghelescu
- Department of Psychiatry and Psychotherapy, Mental Health Institute Berlin, Berlin, 14050, Germany
| | - Bernhardt T Baune
- Department of Psychiatry, University of Münster, Münster, 48149, Germany
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
| | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, 80336, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, 48149, Germany
| | - Detlef E Dietrich
- AMEOS Clinical Center Hildesheim, Hildesheim, 31135, Germany
- Center for Systems Neuroscience (ZSN), Hannover, 30559, Germany
- Department of Psychiatry, Medical School of Hannover, Hannover, 30625, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, 80336, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University of Tübingen, Tübingen, 72076, Germany
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, 86156, Germany
| | - Maria Heilbronner
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, 80336, Germany
| | - Markus Jäger
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, 89312, Germany
| | - Georg Juckel
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, 44791, Germany
| | - Janos L Kalman
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, 80336, Germany
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, 80336, Germany
| | - Carsten Konrad
- Department of Psychiatry and Psychotherapy, Agaplesion Diakonieklinikum, Rotenburg, 27356, Germany
| | - Mojtaba Oraki Kohshour
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, 80336, Germany
- Department of Immunology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sergi Papiol
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, 80336, Germany
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, 80336, Germany
| | - Daniela Reich-Erkelenz
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, 80336, Germany
| | - Jens Reimer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
- Department of Psychiatry, Health North Hospital Group, Bremen, 28102, Germany
| | - Sabrina K Schaupp
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, 80336, Germany
| | - Max Schmauß
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, 86156, Germany
| | - Simon Senner
- Center for Psychiatry Reichenau, Academic Hospital University of Konstanz, Konstanz, 78479, Germany
| | - Carsten Spitzer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock, 18147, Germany
| | - Thomas Vogl
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, 80336, Germany
| | - Jörg Zimmermann
- Psychiatrieverbund Oldenburger Land gGmbH, Karl-Jaspers-Klinik, Bad Zwischenahn, 26160, Germany
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, 80336, Germany
| | - Eva C Schulte
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, 80336, Germany
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, 80336, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Medical Faculty, University of Bonn, Bonn, 53105, Germany
- Institute of Human Genetics, University Hospital Bonn, Medical Faculty, University of Bonn, Bonn, 53127, Germany
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, 80336, Germany
- Department of Psychiatry and Behavorial Sciences, SUNY Upstate Medical University, Syracuse, 54, NY, USA
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Neurobiology and Anthropometrics in Bipolar Affective Disorder, Medical University of Graz, Graz, 8036, Austria
| | - Sophie-Kathrin Kirchner
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, 80336, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, 86156, Germany
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Neurobiology and Anthropometrics in Bipolar Affective Disorder, Medical University of Graz, Graz, 8036, Austria
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