¹Mental Health Research Institute of Tomsk NRMC, Affective States Department, Tomsk, Russian Federation, ²Mental Health Research Institute of Tomsk NRMC, Administration, Tomsk, Russian Federation

Background: The most promising way to improve public health is a strategy to increase adherence to treatment, even compared to efforts to create and develop new effective treatments [1]. Patients with bipolar disorder (BD) often have low levels of adherence to treatment, which has been demonstrated in numerous studies using various assessment methods [2, 3, 4, 5, 6, 7].

Aims & Objectives: To identify influence of psychiatric comorbidity on the level of adherence to psychopharmacotherapy in patients with bipolar disorder.

Method: 106 inpatients diagnosed with BD were examined. Inclusion criteria were: diagnosis of BD according to ICD-10 criteria; previously prescribed pharmacotherapy for BD; age from 18 to 65 years; patient consent to participate in the study and patient’s compliance with therapy. Exclusion criteria: primary patient seeking psychiatric care; pregnancy; dementia; schizophrenia. Evaluation of adherence to therapy was comprehensive: clinical interviews; anamnestic data from people who knew the patient well; determination of the concentration of normothymic medication in the blood. In the study group, women constituted 56.6% (n=60), men 43.4% (n=46). The median age of male patients was 34 [29; 41] years, and of female patients was 32 [25; 48] years.

Results: In the study group, 59 patients (55.7%) had another mental disorder in addition to BD: alcohol dependence, anxiety spectrum disorders, personality disorder. An assessment of the level of adherence taking into account the comorbidity of BD with other mental disorders revealed more frequent violations of doctor's recommendations by patients with the specified comorbidity, compared to patients with “isolated” BD: 69.5% and 48.9% (Pearson Chi-square: 4.620, p=0.03).

Discussion & Conclusions: The presence of psychiatric comorbidity in BD negatively affects patients' adherence to long-term psychopharmacotherapy.
Literature:

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