Treatment non-adherence in affective disorders

Acta Psychiatr Scand. 2002 Mar;105(3):164-72. doi: 10.1034/j.1600-0447.2002.1r084.x.


Objective: The aim of this paper is to review the prevalence, predictors and methods for improving medication adherence in unipolar and bipolar affective disorders.

Method: Studies were identified through Medline and PsycLit searches of English language publications between 1976 and 2001. This was supplemented by a hand search and the inclusion of selected descriptive articles on good clinical practice.

Results: Estimates of medication non-adherence for unipolar and bipolar disorders range from 10 to 60% (median 40%). This prevalence has not changed significantly with the introduction of new medications. There is evidence that attitudes and beliefs are at least as important as side-effects in predicting adherence. The limited number of empirical studies of how to reduce non-adherence offer encouraging evidence that, if recognized, the problem can be overcome.

Conclusion: Only 1-2% of all publications on the treatment of affective disorders explore factors associated with medication non-adherence. This is disappointing as research and clinical data highlight the importance of extended courses of medication in improving the long-term prognosis of affective disorders.

Publication types

  • Review

MeSH terms

  • Antidepressive Agents / adverse effects
  • Antidepressive Agents / therapeutic use
  • Attitude to Health
  • Bipolar Disorder / drug therapy
  • Bipolar Disorder / psychology*
  • Culture
  • Defense Mechanisms
  • Depressive Disorder / drug therapy
  • Depressive Disorder / psychology*
  • Humans
  • Patient Education as Topic
  • Physician-Patient Relations
  • Prognosis
  • Secondary Prevention
  • Surveys and Questionnaires
  • Tranquilizing Agents / adverse effects
  • Tranquilizing Agents / therapeutic use
  • Treatment Refusal / psychology*


  • Antidepressive Agents
  • Tranquilizing Agents