Background: Noncompliance is a major problem for patients with a psychotic disorder. Two important risk factors for noncompliance that have a severe negative impact on treatment outcomes are impaired illness insight and lack of motivation. Our cross-sectional study explored how they are related to each other and their compliance with depot medication. Methods: Interviews were conducted in 169 outpatients with a psychotic disorder taking depot medication. Four patient groups were defined based on low or high illness insight and on low or high motivation. The associations between depot-medication compliance, motivation, and insight were illustrated using generalized linear models. Results: Generalized linear model showed a significant interaction effect between motivation and insight. Patients with poor insight and high motivation for treatment were more compliant (94%) (95% confidence interval [CI]: 1.821, 3.489) with their depot medication than patients with poor insight and low motivation (61%) (95% CI: 0.288, 0.615). Patients with both insight and high motivation for treatment were less compliant (73%) (95% CI: 0.719, 1.315) than those with poor insight and high motivation. Conclusion: Motivation for treatment was more strongly associated with depot-medication compliance than with illness insight. Being motivated to take medication, whether to get better or for other reasons, may be a more important factor than having illness insight in terms of improving depot-medication compliance. Possible implications for clinical practice are discussed

Depot medication, Illness insight, Motivation, Noncompliance, Psychotic disorder, Schizophrenia,
Neuropsychiatric Disease and Treatment
Department of Psychiatry

Noordraven, E.L, Wierdsma, A.I, Blanken, P, Bloemendaal, A.F.T, & Mulder, C.L. (2016). Depot-medication compliance for patients with psychotic disorders: The importance of illness insight and treatment motivation. Neuropsychiatric Disease and Treatment, 12, 269–274. doi:10.2147/NDT.S97883