PDF icon Download PDF
Fortschr Neurol Psychiatr 2011; 79(2): 73-82
DOI: 10.1055/s-0029-1245622
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Kognitive Leistungen und Adhärenzverhalten bei Patienten mit schizophrenen Psychosen

Adherence and Cognitive Performance in SchizophreniaA. Spiekermann1 , M. Schulz1 , J. Behrens2 , M. Driessen1 , E. Rahn3 , T. Beblo1
  • 1Abteilung für Forschung, Qualitätssicherung und Dokumentation, Klinik für Psychiatrie und Psychotherapie Bethel
  • 2Institut für Gesundheits- und Pflegewissenschaft, Martin-Luther-Universität Halle-Wittenberg
  • 3Abteilung Allgemeinpsychiatrie, LWL-Kliniken Warstein und Lippstadt
Further Information

Publication History

Publication Date:
24 November 2010 (online)

Also available ateRef
   Permissions and Reprints
Preview

Zusammenfassung

Hintergrund: Es ist bekannt, dass viele Patienten mit schizophrenen Erkrankungen Non-Adhärenz bzgl. der regelmäßigen Einnahme antipsychotischer Medikamente zeigen. Zum anderen weisen viele Studien auf kognitive Defizite der Betroffenen hin. In dieser Übersichtsarbeit sollen die Ergebnisse von Studien, die den Zusammenhang von Non-Adhärenz und kognitiver Leistungsfähigkeit untersucht haben, gegenübergestellt werden. Methode: Mittels einer systematischen Literaturrecherche wurde der Zusammenhang kognitiver Leistungsparameter mit dem Ausmaß der Adhärenz schizophrener Patienten untersucht. Ergebnisse: Es konnten 18 Studien ermittelt werden, in welchen der Zusammenhang zwischen kognitiver Leistungsfähigkeit und adhärentem Verhalten untersucht wurde. Ein Großteil der Studien belegt, dass Patienten mit stärkeren kognitiven Beeinträchtigungen weniger adhärentes Verhalten zeigen. Die möglichen kausalen Mechanismen dieses Zusammenhangs werden diskutiert.

Abstract

Background: It is known that many patients with schizophrenia show non-adherence with regard to antipsychotic medication. Furthermore, many studies indicate cognitive deficits in schizophrenic patients. In this review, we compare the results of studies examining the relationship of non-adherence and cognitive performance. Method: Based on a systematic literature review, the impact of cognitive performance on the adherence behaviour of patients with schizophrenia was examined. Results: We found 18 studies analysing the impact of cognitive performance on adherence behaviour. Most studies indicated that patients with stronger cognitive impairments show lower adherence behaviour. Possible causal mechanisms are discussed.

Schlüsselwörter

Adhärenz - Compliance - Schizophrenie - Neurokognition - kognitive Beeinträchtigungen

Keywords

adherence - compliance - schizophrenia - neurocognition - cognitive impairment

Literatur

  • 1 Heinrichs R W, Zakzanis K K. Neurocognitive deficit in schizophrenia: a quantitative review of the evidence.  Neuropsychology. 1998;  12 426-445
    Search in Google Scholar
  • 2 Nuechterlein K H, Barch D M, Gold J M et al. Identification of separable cognitive factors in schizophrenia.  Schizophr Res. 2004;  72 29-39
    Search in Google Scholar
  • 3 Bowie C R, Leung W W, Reichenberg A et al. Predicting schizophrenia patients’ real-world behavior with specific neuropsychological and functional capacity measures.  Biol Psychiatry. 2008;  63 505-511
    Search in Google Scholar
  • 4 Szöke A, Trandafir A, Dupont M E et al. Longitudinal studies of cognition in schizophrenia: meta-analysis.  Br J Psychiatry. 2008;  192 248-257
    Search in Google Scholar
  • 5 Cramer J A, Rosenheck R. Compliance with medication regimens for mental and physical disorders.  Psychiatr Serv. 1998;  49 196-201
    Search in Google Scholar
  • 6 Lieberman J A, Stroup T S, McEvoy J P et al. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia.  N Engl J Med. 2005;  353 1209-1223
    Search in Google Scholar
  • 7 Haynes R B. Introduction. In: Haynes R B, Taylor D W, Sacket D L, ed Compliance in Health Care.. Baltimore: John Hopkins Press; 1979: 1-10
    Search in Google Scholar
  • 8 Puschner B, Born A, Giessler A et al. Compliance-Interventionen in der medikamentösen Behandlung Schizophrenieerkrankter – Befunde aktueller Ubersichtsarbeiten.  Psychiatr Prax. 2005;  32 62-67
    Search in Google Scholar
  • 9 Adherence to long term therapy: evidence for action. 2003 http://www.who.int/chp/knowledge/publications/adherence_report/en/ Accessed 25.09.2009
    Search in Google Scholar
  • 10 Seemann U, Kissling W. Volkskrankheit „Noncompliance” – Ursachen, Folgen, Therapiemöglichkeiten.  Psychoneuro. 2008;  34 405-409
    Search in Google Scholar
  • 11 Sajatovic M, Velligan D I, Weiden P J et al. Measurement of psychiatric treatment adherence.  Journal of Psychosomatic Research. [Epub ahead of print]
  • 12 Weiden P J, Olfson M. Cost of relapse in schizophrenia.  Schizophr Bull. 1995;  21 419-429
    Search in Google Scholar
  • 13 Chen E Y, Hui C L, Dunn E L et al. A prospective 3-year longitudinal study of cognitive predictors of relapse in first-episode schizophrenic patients.  Schizophr Res. 2005;  77 99-104
    Search in Google Scholar
  • 14 Patterson T L, Lacro J, McKibbin C L et al. Medication management ability assessment: results from a performance-based measure in older outpatients with schizophrenia.  J Clin Psychopharmacol. 2002;  22 11-19
    Search in Google Scholar
  • 15 Jeste S D, Patterson T L, Palmer B W et al. Cognitive predictors of medication adherence among middle-aged and older outpatients with schizophrenia.  Schizophr Res. 2003;  63 49-58
    Search in Google Scholar
  • 16 Heinrichs R W, Goldberg J O, Miles A A et al. Predictors of medication competence in schizophrenia patients.  Psychiatry Res. 2008;  157 47-52
    Search in Google Scholar
  • 17 Kurtz M M, Baker E, Pearlson G D et al. A virtual reality apartment as a measure of medication management skills in patients with schizophrenia: a pilot study.  Schizophr Bull. 2007;  33 1162-1170
    Search in Google Scholar
  • 18 Hogan T P, Awad A G, Eastwood R. A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity.  Psychol Med. 1983;  13 177-183
    Search in Google Scholar
  • 19 Goodman C, Knoll G, Isakov V et al. Negative attitude towards medication is associated with working memory impairment in schizophrenia patients.  Int Clin Psychopharmacol. 2005;  20 93-96
    Search in Google Scholar
  • 20 Kim S W, Shin I S, Kim J M et al. Association between attitude toward medication and neurocognitive function in schizophrenia.  Clin Neuropharmacol. 2006;  29 197-205
    Search in Google Scholar
  • 21 Cuffel B J, Alford J, Fischer E P et al. Awareness of illness in schizophrenia and outpatient treatment adherence.  J Nerv Ment Dis. 1996;  184 653-659
    Search in Google Scholar
  • 22 Weiden P, Rapkin B, Mott T et al. Rating of medication influences (ROMI) scale in schizophrenia.  Schizophr Bull. 1994;  20 297-310
    Search in Google Scholar
  • 23 Maeda K, Kasai K, Watanabe A et al. Effect of subjective reasoning and neurocognition on medication adherence for persons with schizophrenia.  Psychiatr Serv. 2006;  57 1203-1205
    Search in Google Scholar
  • 24 Vauth R, Loschmann C, Rusch N et al. Understanding adherence to neuroleptic treatment in schizophreniai.  Psychiatry Res. 2004;  126 43-49
    Search in Google Scholar
  • 25 Sapra M, Vahia I V, Reyes P N et al. Subjective reasons for adherence to psychotropic medication and associated factors among older adults with schizophrenia.  Schizophr Res. 2008;  106 348-355
    Search in Google Scholar
  • 26 David A S. Insight and psychosis.  Br J Psychiatry. 1990;  156 798-808
    Search in Google Scholar
  • 27 McCabe R, Quayle E, Beirne A D et al. Insight, global neuropsychological functioning, and symptomatology in chronic schizophrenia.  J Nerv Ment Dis. 2002;  190 519-525
    Search in Google Scholar
  • 28 Kemp R, David A. Psychological predictors of insight and compliance in psychotic patients.  Br J Psychiatry. 1996;  169 444-450
    Search in Google Scholar
  • 29 Smith T E, Hull J W, Goodman M et al. The relative influences of symptoms, insight, and neurocognition on social adjustment in schizophrenia and schizoaffective disorder.  J Nerv Ment Dis. 1999;  187 102-108
    Search in Google Scholar
  • 30 Donohoe G, Owens N, O"Donnell C et al. Predictors of compliance with neuroleptic medication among inpatients with schizophrenia: a discriminant function analysis.  Eur Psychiatry. 2001;  16 293-298
    Search in Google Scholar
  • 31 Verdoux H, Liraud F, Assens F et al. Social and clinical consequences of cognitive deficits in early psychosis: a two-year follow-up study of first-admitted patients.  Schizophr Res. 2002;  56 149-159
    Search in Google Scholar
  • 32 Perkins D O, Gu H, Weiden P J et al. Predictors of treatment discontinuation and medication nonadherence in patients recovering from a first episode of schizophrenia, schizophreniform disorder, or schizoaffective disorder: a randomized, double-blind, flexible-dose, multicenter study.  J Clin Psychiatry. 2008;  69 106-113
    Search in Google Scholar
  • 33 Robinson D G, Woerner M G, Alvir J M et al. Predictors of medication discontinuation by patients with first-episode schizophrenia and schizoaffective disorder.  Schizophr Res. 2002;  57 209-219
    Search in Google Scholar
  • 34 Martinez-Aran A, Scott J, Colom F et al. Treatment nonadherence and neurocognitive impairment in bipolar disorder.  J Clin Psychiatry. 2009;  70 1017-1023
    Search in Google Scholar
  • 35 Haslbeck J W, Schaeffer D. Selbstverantwortung im Gesundheitswesen, diskutiert am Medikamentenmanagement aus Sicht chronisch kranker Patienten.  Gesundheitswesen. DOI: 10.1055 /s-0030-1247 539
  • 36 Gray R, White J, Schulz M et al. Enhancing medication adherence in people with schizophrenia: an international programme of research.  Int J Ment Health Nurs. 2010;  19 36-44
    Search in Google Scholar
  • 37 Miller W R, Rollnick S. Motivierende Gesprächsführung – Ein Konzept zur Beratung von Menschen mit Suchtproblemen. Lambertus; Freiburg im Breisgau; 1999
    Search in Google Scholar
  • 38 Kemp R, Kirov G, Everitt B et al. Randomised controlled trial of compliance therapy. 18-month follow-up.  Br J Psychiatry. 1998;  172 413-419
    Search in Google Scholar
  • 39 McGurk S R, Twamley E W, Sitzer D I et al. A meta-analysis of cognitive remediation in schizophrenia.  Am J Psychiatry. 2007;  164 1791-1802
    Search in Google Scholar
  • 40 Claxton A J, Cramer J, Pierce C. A systematic review of the associations between dose regimens and medication compliance.  Clin Ther. 2001;  23 1296-1310
    Search in Google Scholar
  • 41 Diaz E, Neuse E, Sullivan M C et al. Adherence to conventional and atypical antipsychotics after hospital discharge.  J Clin Psychiatry. 2004;  65 354-360
    Search in Google Scholar
  • 42 Keshavan M S, Rabinowitz J, DeSmedt G et al. Correlates of insight in first episode psychosis.  Schizophr Res. 2004;  70 187-194
    Search in Google Scholar
  • 43 Lysaker P H, Buck K D, Salvatore G et al. Lack of awareness of illness in schizophrenia: conceptualizations, correlates and treatment approaches.  Expert Rev Neurother. 2009;  9 1035-1043
    Search in Google Scholar
  • 44 Minzenberg M J, Poole J H, Benton C et al. Association of anticholinergic load with impairment of complex attention and memory in schizophrenia.  Am J Psychiatry. 2004;  161 116-1124
    Search in Google Scholar
  • 45 Benkert O, Hippius H. Kompendium der Psychiatrischen Pharmakotherapie. Springer. Heidelberg; 2005
    Search in Google Scholar
  • 46 Hui C L, Chen E Y, Kan C et al. Anti-psychotics adherence among out-patients with schizophrenia in Hong Kong.  Keio J Med. 2006;  55 9-14
    Search in Google Scholar
  • 47 Bender S, Dittmann-Balcar A. Kognitives Training bei Schizophrenie. In: Kircher T, Gauggel S, eds Neuropsychologie der Schizophrenie -Symptome, Kognition, Gehirn.. Heidelberg: Springer; 2008: 589-598
    Search in Google Scholar
  • 48 Folstein M F, Folstein S E, McHugh P R. „Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician.  J Psychiatr Res. 1975;  12 189-198
    Search in Google Scholar
  • 49 Mattis S ed. Dementia Rating Scale Psychological Assessment Resources. Odessa, FL; 1973
    Search in Google Scholar
  • 50 Wilkinson G S. The Wide Range Achievement Test Administration Manual. Wide Range. Wilmington, DE; 1993
    Search in Google Scholar
  • 51 Wechsler D. Wechsler Adult Intelligence Scale – Third Edition. The Psychological Corporation. San Antonio, TX; 1997
    Search in Google Scholar
  • 52 Delis D D, Kramer J, Kaplan E et al. California Verbal Learning Test – Second Edition. The Psychological Corporation. San Antonio, TX; 2000
    Search in Google Scholar
  • 53 Cornblatt B A, Risch N J, Faris G et al. The Continuous Performance Test, identical pairs version (CPT-IP): I. New findings about sustained attention in normal families.  Psychiatry Res. 1988;  26 223-238
    Search in Google Scholar
  • 54 Wetzel L, Boll T J. Short Category Test, Booklet Format. Western Psychological Services. Los Angeles, Californien; 1986
    Search in Google Scholar
  • 55 Shapiro A M, Benedict R H, Schretlen D et al. Construct and concurrent validity of the Hopkins Verbal Learning Test-revised.  Clin Neuropsychol. 1999;  13 348-358
    Search in Google Scholar
  • 56 Miklowitz D J, Goldstein M J, Nuechterlein K H et al. Expressed emotion, affective style, lithium compliance, and relapse in recent onset mania.  Psychopharmacol Bull. 1986;  22 628-632
    Search in Google Scholar
  • 57 Northern California Neurobehavioral Group I .Manual for the Neurobehavioral Cognitive Status Examination. Author. Fairfax, CA; 1988
    Search in Google Scholar
  • 58 Wechsler D. Wechsler Adult Intelligence Manual. Psychological Corporation. New York; 1955
    Search in Google Scholar
  • 59 Benton A, Hannay H J, Varney N R. Visual perception of line direction in patients with unilateral brain disease.  Neurology. 1975;  25 907-910
    Search in Google Scholar
  • 60 Glahn D C, Gur R C, Ragland J D et al. Reliability, performance characteristics, construct validity, and an initial clinical application of a visual object learning test (VOLT).  Neuropsychology. 1997;  11 602-612
    Search in Google Scholar
  • 61 Gur R C, Jaggi J L, Ragland J D et al. Effects of memory processing on regional brain activation: cerebral blood flow in normal subjects.  Int J Neurosci. 1993;  72 31-44
    Search in Google Scholar
  • 62 Gur R C, Ragland J D, Moberg P J et al. Computerized neurocognitive scanning: II. The profile of schizophrenia.  Neuropsychopharmacology. 2001;  25 777-788
    Search in Google Scholar
  • 63 Wechsler D. Wechsler Adult Intelligence Scale- Revised Manual. Psychological Corporation. New York; 1981
    Search in Google Scholar
  • 64 Rey A. LÉxamen Clinique en Psychologie. Presses Universitaires de France. Paris; 1964
    Search in Google Scholar
  • 65 Heaton R K, Chelune G J, Talley J L et al. Wisconsin Card Sorting Test Manual. Psychological Assessment Resources. FL. Odessa; 1993
    Search in Google Scholar
  • 66 Nuechterlein K H, Dawson M E, Green M F. Information-processing abnormalities as neuropsychological vulnerability indicators for schizophrenia.  Acta Psychiatr Scand Suppl. 1994;  384 71-79
    Search in Google Scholar
  • 67 Lezak M D. Neuropsychological assessment. Oxford University Press. New York; 1995 3 rd ed
    Search in Google Scholar
  • 68 Nuechterlein K H. Vigilance in schizophrenia and related disorders. In: Steinhauer S R, Gruzelier J H, eds Handbook of Schizophrenia: Neuropsychology, Psychophysiology and Information Processing.. Amsterdam: Elsevier Science Publishing; 1991: 397-433
    Search in Google Scholar
  • 69 Wechsler D. WMS-R Wechsler Memory Scale- Revised. Manual. The Psychological Corporation. Harcourt Brace Jovanovich, Inc, New York; 1987
    Search in Google Scholar
  • 70 Härting C, Makowitsch H J. Wechsler Gedächtnis Test. Deutsche Adaptation der revidierten Fassung der Wechsler-Memory-Scale (WMS-R). Manual. Hogrefe. Göttingen; 1998
    Search in Google Scholar
  • 71 Lezak M D. Neuropsychological Assessment. Oxford University Press. New York; 1983
    Search in Google Scholar
  • 72 Golden C J, Moses J A, Graber B et al. Luria- nebraska neuropsychological battery: Forms I and II manual. Western Psychological Services. California; 1991
    Search in Google Scholar
  • 73 Nelson H E, O’Connell A. Dementia: the estimation of premorbid intelligence levels using the New Adult Reading Test.  Cortex. 1978;  14 234-244
    Search in Google Scholar
  • 74 Reitan R M. Validity of the trail making test as an indicator of organic brain damage.  Perceptual and motor speed. 1958;  8 271-276
    Search in Google Scholar
  • 75 Asarnow R F, Granholm E, Sherman T. Span of apprehension in schizophrenia. In: Steinhauer S R, Gruzelier J H, Zubin J, eds Handbook of schizophrenia: Neuropsychology, psychophysiology and information processing. Amsterdam: Elsevier; 1991: 335-370
    Search in Google Scholar
  • 76 Oltmanns T F, Neale J M. Schizophrenic performance when distractors are present: attentional deficit or differential task difficulty?.  J Abnorm Psychol. 1975;  84 205-209
    Search in Google Scholar
  • 77 Nelson H E, O’Connell. A National Adult Reading Test (NART). Test Manual 1984. NFER. Windsor; 1984
    Search in Google Scholar
  • 78 Warrington E K. Recognition Memory Test, Manual 1984. NFER- Nelson. Berkshire; 1984
    Search in Google Scholar
  • 79 Stroop J R. Studies of interference in serial verbal reactions.  Journal of Experimental Psychology. 1935;  18 643-661
    Search in Google Scholar
  • 80 Heaton R K. The Wisconsin Card Sorting Test (Manual). Psychological Assessment Resources. Odessa, FL; 1981
    Search in Google Scholar
  • 81 Signoret J L. BEM-84, Batterie d’Efficience Mnésique réduite. Editions Scientifiques Elsevier. Paris; 1991
    Search in Google Scholar
  • 82 Bilder R M, Goldman R S, Robinson D et al. Neuropsychology of first-episode schizophrenia: initial characterization and clinical correlates.  Am J Psychiatry. 2000;  157 549-559
    Search in Google Scholar
  • 83 Hong-Kong-Psychological-Society .The Wechsler Adult Intelligence Scale – Revised (Cantonese version). Hong Kong Psychological Society. Hong Kong; 1989
    Search in Google Scholar
  • 84 Nelson H E. A modified card sorting test sensitive to frontal lobe defects.  Cortex. 1976;  12 313-324
    Search in Google Scholar

Alexa Spiekermann

Abteilung für Forschung, Qualitätssicherung und DokumentationKlinik für Psychiatrie und Psychotherapie Bethel

Remterweg 69 / 71

33617 Bielefeld

Email: alexa_spiekermann@gmx.de