Study Finds Low Medication Adherence Among Young People After First Psychotic Episode

A large retrospective study has found that fewer than one in five young people who began antipsychotic treatment following a first episode of psychosis remained consistently adherent to their medication during the following year. The findings were reported by Psychiatric Times based on a study published in JAMA Network Open.

Researchers analysed insurance claims covering patients between 15 and 40 years of age. From an initial group of 27,592 people identified as having experienced a first episode of psychosis, 11,889 subsequently filled a first antipsychotic prescription and were included in the main analysis.

Medication adherence was assessed over 365 days using the proportion of days covered (PDC). Researchers classified patients as adherent when medication coverage reached at least 80 per cent of the follow-up period. Only 19.1 per cent of the study group met this threshold. On average, participants had medication coverage for approximately 43 per cent of the year.

Adherence differed according to diagnosis. It was highest among patients with schizophrenia-spectrum disorders, at 23.1 per cent, compared with 16.9 per cent among those with mood disorders accompanied by psychotic features and 13.5 per cent among patients with other psychotic-spectrum disorders.

The study also found differences in healthcare use. Patients who maintained medication adherence had fewer emergency-department visits and more behavioural-health outpatient visits. However, adherence was not significantly associated with psychiatric or general hospitalisation rates.

Long-acting injectable antipsychotics were rarely used when treatment began. More than 95 per cent of patients received oral medication alone, while only a small proportion received injectable treatment either alone or alongside oral medication.

The researchers noted that claims data cannot confirm whether patients actually took every medication they obtained. Nevertheless, the findings point to challenges in maintaining treatment continuity during the early stages of psychosis and support further research into strategies that can improve adherence and engagement with outpatient care.

28-09-2026