Treatment adherence and illness insight in veterans with bipolar disorder

Laurel A. Copeland, John E. Zeber, Ihsan M. Salloum, Harold A. Pincus, Michael J. Fine, Amy M. Kilbourne

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Insight into the perceived value of psychotherapy and pharmacological treatment may improve adherence to medication regimens among patients with bipolar disorder, because patients are more likely to take medication they believe will make them better. We conducted a cross-sectional survey of patients recruited into the Continuous Improvement for Veterans in Care-Mood Disorders (CIVIC-MD; July 2004-July 2006), assessing therapeutic insight and 2 measures of medication adherence: the Morisky scale of intrapersonal barriers and missing any doses the previous 4 days. Among 435 patients with bipolar disorder, 27% had poor adherence based on missed dose and 46% had poor adherence based on the Morisky. In multivariable models, greater insight into medication was negatively associated with both measures of poor adherence. Odds of poor adherence increased for women, African Americans, mania, and hazardous drinking. The association of mutable factors-hazardous drinking, manic symptoms, and insight-could represent an opportunity to improve adherence.

Original languageEnglish (US)
Pages (from-to)16-21
Number of pages6
JournalJournal of Nervous and Mental Disease
Issue number1
StatePublished - Jan 2008
Externally publishedYes


  • Bipolar disorder
  • Illness insight
  • Patient acceptance of health care
  • Patient nonadherence
  • Veterans

ASJC Scopus subject areas

  • Psychiatry and Mental health


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