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首页> 外文期刊>The journal of clinical psychiatry >Factors associated with medication adherence in African American and white patients with bipolar disorder.
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Factors associated with medication adherence in African American and white patients with bipolar disorder.

机译：非裔美国人和白人双相情感障碍患者中与药物依从性相关的因素。

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BACKGROUND: African American patients may be less likely than white patients to adhere to maintenance pharmacotherapy for bipolar disorder. The purpose of this study was to examine rates of medication nonadherence, self-perceived reasons for nonadherence, and attitudes associated with non-adherence in these ethnic groups. METHOD: 20 African American and 30 white subjects with DSM-IV bipolar I disorder participated in this study. At a single follow-up visit with patients at least 4 months after their first hospitalization for acute mania, we assessed demographics, symptom severity, degrees of adherence, reasons for non-adherence, and self-perceptions regarding factors previously associated with nonadherence using a visual analog scale (VAS). The cross-sectional data that are the subject of this report were obtained from July 1, 2002, through June 30, 2004. RESULTS: Over 50% of participants in each group were currently either fully or partially nonadherent with medications. Greater than 20% of participants in each group denied having bipolar disorder and described physical side effects from medications as contributing to nonadherence. In principal components analysis of the VAS, 2 components were identified. The first component contained patient-related factors associated with nonadherence, while the second contained a combination of illness- and medication-related factors. African American participants were more likely to endorse patient-related factors associated with nonadherence relative to white participants. Specifically, African Americans self-endorsed a fear of becoming addicted to medications and feeling that medications were symbols of mental illness. CONCLUSION: Findings suggest that both African American and white patients with bipolar disorder demonstrate poor medication adherence that they attribute to illness/medication-related factors (denial of illness, physical side effects). However, patient-related factors (fear of addiction, medication as a symbol of illness) accounted for ethnic differences on self-perceived ratings of nonadherence factors. Differences in the reasons for nonadherence relative to culturally biased self-perceptions may help explain nonadherence behaviors in the African American community.
机译：背景：非裔美国人患者比白人患者接受双相情感障碍维持药物治疗的可能性更低。这项研究的目的是检查在这些族裔群体中药物不依从率，不依从的自我感觉原因以及与不依从相关的态度。方法：20名非裔美国人和30名患有DSM-IV双相性I型障碍的白人受试者参加了这项研究。在患者首次因急性躁狂住院至少4个月后进行的单次随访中，我们评估了人口统计学，症状严重程度，依从程度，不依从的原因以及对先前与不依从相关的因素的自我认知，方法是使用视觉模拟量表（VAS）。本报告涉及的横断面数据是从2002年7月1日至2004年6月30日获得的。结果：每组中超过50％的参与者目前完全或部分不服药。每组中超过20％的参与者否认患有躁郁症，并描述了药物引起的身体副作用导致不依从性。在VAS的主成分分析中，确定了2个成分。第一部分包含与不依从相关的患者相关因素，而第二部分包含疾病和药物相关因素的组合。相对于白人参与者，非裔美国人参与者更有可能认可与不依从相关的患者相关因素。特别是，非洲裔美国人自我认可担心会沉迷于药物，并感到药物是精神疾病的象征。结论：研究结果表明，患有双相情感障碍的非洲裔美国人和白人患者均表现出不良的药物依从性，这归因于疾病/药物相关因素（拒绝疾病，身体副作用）。但是，与患者相关的因素（对成瘾的恐惧，用药物治疗作为疾病的象征）解释了对非依从性因素自我评价的种族差异。相对于文化偏见的自我理解，不遵守的原因有所不同，这可能有助于解释非裔美国人社区中的不遵守行为。

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