Does augmentation with antipsychotic agents affect the medication adherence of the child with obsessive-compulsive disorder?

Abstract

Antipsychotic agents can be used for augmentation when the response to treatment is insufficient in children with obsessive compulsive disorder. Our aim was to investigate adherence to treatment between patients with and without antipsychotic augmentation and factors potentially related to this. One hundred fourteen children and adolescents aged 8-18 years diagnosed with OCD and still receiving treatment were included in the study. Fifty-two subjects were received antipsychotic therapy for augmentation, while 62 were not receiving it. All subjects were evaluated using a sociodemographic data form, the 8-item Morisky Medication Adherence Scale (MMAS-8), and the Udvalg for Klinikse Undersegelser (UKU) side-effects rating scale. The results were then subjected to statistical analysis. Total MMAS-8 scores were statistically significantly lower in the augmentation group than in the monotherapy group (p: 0.01). Sex, receipt of psychotherapy and family monitoring of treatment had no effect on total MMAS-8 scores (p: 0.949, p: 0.394, and p: 0.198, respectively). Higher UKU side-effect rating scale scores were determined in the augmentation group compared to the monotherapy group (p<0.05). Correlation analysis revealed that UKU total score (r:-0.272, p:0.003) and UKU psychological side-effects subscale score (r:-0.263, p:0.005) were significantly inversely correlated with MMAS-8 total scores. Side-effects deriving from medications affected adherence to treatment more significantly than several other environmental factors in children with OCD. Our findings show the need for side-effects, and particularly psychological side-effects, the frequency of which increases with augmentation, to be monitored in terms of adherence to treatment.