Of 168 consecutive referrals, 96 patients met the criteria for schizophrenic disorders. Forty six patients were excluded; 21 were not recent onset, 4 had substance abuse, 4 lived outside of the catchment area, 4 would not give written consent, 2 had mental retardation and 11 did not recover from the initial psychotic episode. One of the included patients moved to another region and 6 patients received limited psychosocial treatment and follow-up. However, it was possible to reach all patients for evaluations. Demographic and clinical characteristics at baseline are shown in Table . The 19 women and 31 men who were included in the study came from hospital wards (57 %), outpatient clinics (23 %) and general practitioners (21 %). Patients were clinically stable at baseline and were assumed to be adherent with medication. At the end of the study, 5 (10 %) patients revealed that they did not take their medication as prescribed at baseline. All the patients had been prescribed antipsychotic medication. During the 2 years, 37/50 patients were given first generation antipsychotics, 12/50 patients were given second generation antipsychotics excluding clozapine and 16/50 were given clozapine.
Baseline characteristics of the 50 included patients.
Good adherence was found in 19 of 29 patients that anytime during the trial received oral first generation antipsychotics, 10 of 12 patients that anytime during the trial received second generation antipsychotics and 12 of 16 patients receiving clozapine (ChiSqu = 1.44 df = 2, p = 0.5). Among patients with only one medication during the whole trial, good adherence was found in 11 of 17 receiving oral first generation antipsychotics, 3 of 4 receiving second generation antipsychotics and 5 of 7 receiving clozapine (ChiSqu = 0.21 df = 2, p = 0.9). Patients with good adherence with oral or depot antipsychotic medication combined were more seldom persistent psychotic, had fewer relapses and admittances to hospital, fewer days in hospital and fewer days in-or outpatient admittance by coercion than patients non-adherent to antipsychotics (Table ). Ten of 20 patients admitted to hospital were non-adherent to oral and depot antipsychotic medication combined while 6 of 30 patients not admitted to hospital were non-adherent to oral and depot antipsychotic medication combined. Eleven of 17 patients with a major recurrence were non-adherent while 5 of 33 patients without a major recurrence were non-adherent to oral or depot antipsychotic medication combined (Table ). Patients with good adherence to oral antipsychotics compared to non-adherent patients and users of depot antipsychotics combined were more seldom persistent psychotic, had fewer relapses, a higher GAF at 2 years and better improvement in GAF during the 2 years (Table ). Users of depot antipsychotics had more major relapses, higher number of hospitalisations, more days admitted by coercion as in-and outpatients and a lesser improvement in GAF through the 2 years compared to patients that not used depot antipsychotics (Table ). Among the 22 patients that were non-adherent to oral antipsychotics, 4 of the 6 women and 7 of the 16 men were admitted to hospital during the 2 years. The non-adherent women had more days outpatient treatment by coercion (p = 0.010, Mann-Whitney test) and more days inpatient treatment by coercion (p = 0.049, Mann-Whitney test) than the non-adherent men (Table ).
Adherence to antipsychotic medication, use of depot antipsychotics, psychotic symptoms, relapse and admittances to hospital through two years in recent onset schizophrenia.
Sex differences in adherence to antipsychotic medication, use of depot antipsychotics, psychotic symptoms, relapse and admittances to hospital through two years in recent onset schizophrenia
Among the 12 patients receiving depot antipsychotics, 8 were treated with depot when included in the study. Of these 8, 2 used depot the whole period with good adherence, 2 had good adherence to depot, changed to oral antipsychotics with bad adherence and 4 had good adherence to depot, changed to oral with good adherence. Four patients used oral antipsychotics when included, had bad adherence and changed to depot antipsychotics with good adherence.
This means that among the 12 patients treated with depot antipsychotics some time during the study, 6 were adherent throughout the 2 years, while 6 were non-adherent. Five of 6 depot users in the non-adherent group had a relapse compared to 3 of 6 in the adherent group. One of 6 depot users in the adherent group and all 6 depot users in the non-adherent group were hospitalised (p = 0.015, Fischer Exact test) (Table ).
Odds for being persistent psychotic, having a relapse or being admitted to hospital for patients adherent or non adherent to antipsychotics or depot users.