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Treatment adherence in bipolar disorder: related factors

Published online by Cambridge University Press:  26 August 2025

F. Sahnoun ,
F. Cherif ,
D. Mnif ,
F. Guermazi ,
I. Baati ,
I. Feki ,
R. Masmoudi  and
J. Masmoudi
F. Sahnoun*
Affiliation:
Psychiatry A Department, Hedi Chaker University hospital, Sfax, Tunisia
F. Cherif
Affiliation:
Psychiatry A Department, Hedi Chaker University hospital, Sfax, Tunisia
D. Mnif
Affiliation:
Psychiatry A Department, Hedi Chaker University hospital, Sfax, Tunisia
F. Guermazi
Affiliation:
Psychiatry A Department, Hedi Chaker University hospital, Sfax, Tunisia
I. Baati
Affiliation:
Psychiatry A Department, Hedi Chaker University hospital, Sfax, Tunisia
I. Feki
Affiliation:
Psychiatry A Department, Hedi Chaker University hospital, Sfax, Tunisia
R. Masmoudi
Affiliation:
Psychiatry A Department, Hedi Chaker University hospital, Sfax, Tunisia
J. Masmoudi
Affiliation:
Psychiatry A Department, Hedi Chaker University hospital, Sfax, Tunisia
*
*Corresponding author.

Abstract

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Introduction

It is well established that user behavior does not align with clinical recommendations regarding using medication in psychotic disorders, particularly bipolar disorder (BD). Nonadherence to treatment carries a high risk of relapse due to the recurrent nature of the illness and is influenced by multiple factors

Objectives

The aim of this study is to investigate the prevalence of medication adherence among BD patients and to explore the various factors contributing to poor adherence.

Methods

This cross-sectional, descriptive, and analytical study was conducted with patient diagnosed with bipolar disorder at the Psychiatry “A” Department of Hedi Chaker University Hospital. Data on clinical and sociodemographic variables were collected between March and September 2023 using a questionnaire, alongside the Medication Adherence Rating Scale (MARS) to evaluate treatment adherence.

Results

A total of 37 patients with BD completed the questionnaire. The mean age was 45.4 ± 13.9 years, with a sex ratio (M/F) of 1.46.

In this study, 73 % of patients had BD type I and 27% had BD type II.

The mean MARS score was 7.14 ± 2.13 and 62.2% were adherent to their treatment.

Only 16.2% of bipolar patients discontinued their medication due to side effects, while 51.4% present unintentional poor adherence.

A significant association was found between treatment adherence and socio-economic status (p = 0.05).

The MARS score was negatively correlated with the number of hospitalizations (p = 0.05, r = -0.315)

Conclusions

This study highlights that treatment adherence in bipolar disorder is influenced by various factors, with socio-economic status being a significant determinant. The negative correlation between MARS scores and the number of hospitalizations suggests that better adherence is associated with fewer hospitalizations. Improving treatment compliance is crucial to reducing the risk of recurrence and hospitalization in BD.

Disclosure of Interest

None Declared

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Type
Abstract
Information
European Psychiatry , Volume 68 , Special Issue S1: Abstracts of the 33rd European Congress of Psychiatry , April 2025 , pp. S524
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of European Psychiatric Association
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