Kognitive Leistungen und Adhärenzverhalten bei Patienten mit schizophrenen Psychosen

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
• 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
• 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
• 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
• 5 Cramer J A, Rosenheck R. Compliance with medication regimens for mental and physical disorders.  Psychiatr Serv. 1998;  49 196-201
• 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
• 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
• 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
• 9 Adherence to long term therapy: evidence for action. 2003 http://www.who.int/chp/knowledge/publications/adherence_report/en/ Accessed 25.09.2009
• 10 Seemann U, Kissling W. Volkskrankheit „Noncompliance” – Ursachen, Folgen, Therapiemöglichkeiten.  Psychoneuro. 2008;  34 405-409
• 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
• 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
• 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
• 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
• 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
• 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
• 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
• 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
• 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
• 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
• 22 Weiden P, Rapkin B, Mott T et al. Rating of medication influences (ROMI) scale in schizophrenia.  Schizophr Bull. 1994;  20 297-310
• 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
• 24 Vauth R, Loschmann C, Rusch N et al. Understanding adherence to neuroleptic treatment in schizophreniai.  Psychiatry Res. 2004;  126 43-49
• 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
• 26 David A S. Insight and psychosis.  Br J Psychiatry. 1990;  156 798-808
• 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
• 28 Kemp R, David A. Psychological predictors of insight and compliance in psychotic patients.  Br J Psychiatry. 1996;  169 444-450
• 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
• 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
• 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
• 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
• 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
• 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
• 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
• 37 Miller W R, Rollnick S. Motivierende Gesprächsführung – Ein Konzept zur Beratung von Menschen mit Suchtproblemen. Lambertus; Freiburg im Breisgau; 1999
• 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
• 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
• 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
• 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
• 42 Keshavan M S, Rabinowitz J, DeSmedt G et al. Correlates of insight in first episode psychosis.  Schizophr Res. 2004;  70 187-194
• 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
• 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
• 45 Benkert O, Hippius H. Kompendium der Psychiatrischen Pharmakotherapie. Springer. Heidelberg; 2005
• 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
• 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
• 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
• 49 Mattis S ed. Dementia Rating Scale Psychological Assessment Resources. Odessa, FL; 1973
• 50 Wilkinson G S. The Wide Range Achievement Test Administration Manual. Wide Range. Wilmington, DE; 1993
• 51 Wechsler D. Wechsler Adult Intelligence Scale – Third Edition. The Psychological Corporation. San Antonio, TX; 1997
• 52 Delis D D, Kramer J, Kaplan E et al. California Verbal Learning Test – Second Edition. The Psychological Corporation. San Antonio, TX; 2000
• 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
• 54 Wetzel L, Boll T J. Short Category Test, Booklet Format. Western Psychological Services. Los Angeles, Californien; 1986
• 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
• 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
• 57 Northern California Neurobehavioral Group I .Manual for the Neurobehavioral Cognitive Status Examination. Author. Fairfax, CA; 1988
• 58 Wechsler D. Wechsler Adult Intelligence Manual. Psychological Corporation. New York; 1955
• 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
• 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
• 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
• 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
• 63 Wechsler D. Wechsler Adult Intelligence Scale- Revised Manual. Psychological Corporation. New York; 1981
• 64 Rey A. LÉxamen Clinique en Psychologie. Presses Universitaires de France. Paris; 1964
• 65 Heaton R K, Chelune G J, Talley J L et al. Wisconsin Card Sorting Test Manual. Psychological Assessment Resources. FL. Odessa; 1993
• 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
• 67 Lezak M D. Neuropsychological assessment. Oxford University Press. New York; 1995 3 rd ed
• 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
• 69 Wechsler D. WMS-R Wechsler Memory Scale- Revised. Manual. The Psychological Corporation. Harcourt Brace Jovanovich, Inc, New York; 1987
• 70 Härting C, Makowitsch H J. Wechsler Gedächtnis Test. Deutsche Adaptation der revidierten Fassung der Wechsler-Memory-Scale (WMS-R). Manual. Hogrefe. Göttingen; 1998
• 71 Lezak M D. Neuropsychological Assessment. Oxford University Press. New York; 1983
• 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
• 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
• 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
• 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
• 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
• 77 Nelson H E, O’Connell. A National Adult Reading Test (NART). Test Manual 1984. NFER. Windsor; 1984
• 78 Warrington E K. Recognition Memory Test, Manual 1984. NFER- Nelson. Berkshire; 1984
• 79 Stroop J R. Studies of interference in serial verbal reactions.  Journal of Experimental Psychology. 1935;  18 643-661
• 80 Heaton R K. The Wisconsin Card Sorting Test (Manual). Psychological Assessment Resources. Odessa, FL; 1981
• 81 Signoret J L. BEM-84, Batterie d’Efficience Mnésique réduite. Editions Scientifiques Elsevier. Paris; 1991
• 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
• 83 Hong-Kong-Psychological-Society .The Wechsler Adult Intelligence Scale – Revised (Cantonese version). Hong Kong Psychological Society. Hong Kong; 1989
• 84 Nelson H E. A modified card sorting test sensitive to frontal lobe defects.  Cortex. 1976;  12 313-324