JMIR Publications

ABSTRACT

Background:

Despite the efficacy of treatment and severity of symptoms, medication adherence by many with bipolar disorder (BD) is variable at best. This poses a significant challenge for BD care management.

Objective:

For this study, we set out to identify psychosocial and psychiatric predictors of medication adherence with BD.

Methods:

Using microtargeted social media advertising, we recruited an international sample of young and older adults with BD living in North America (Canada, USA), Western Europe (e.g., U.K., Ireland) and Australia or New Zealand (N = 92). On average, participants were 55.35 years of age (SD = 9.65; range 22-73 years), had been diagnosed with BD 14.25 years ago (SD = 11.14, range 1- 46 years) and were currently prescribed 2.40 psychotropic medications (SD = 1.28, range 0–6).

Results:

Adherence does not significantly differ across BD subtypes, country of residence nor prescription of lithium versus other mood stabilizers. Path analyses indicate that alcohol misuse and perceived cognitive failures are direct predictors of medication adherence. BD symptoms, psychological well-being and number of comorbid psychiatric conditions emerged as indirect predictors of adherence via cognitive failures.

Conclusions:

Alcohol misuse does not predict cognitive failures. Nor does age predict medication adherence or cognitive failures. This is noteworthy given the 51-year age range of participants. That is, persons in their 20’s with BD reported similar levels of medication adherence and cognitive failures as those in their 60’s. This suggests that perceived cognitive loss is a facet of adult life with BD in contrast to the assumption that accelerated cognitive aging with BD begins in midlife.