Sleep disturbance and treatment adherence: commentary on the study by Bosch et al. (2016)

Kanako Ishizuka, Toshiya Inada
2018 Neuroimmunology and Neuroinflammation  
Treatment adherence is essential for optimizing healthcare outcomes, especially in individuals with schizophrenia or depression [1, 2] . Previous studies identified several factors that predict treatment adherence, including psychiatric diagnoses, patients' characteristics, side-effects of psychotropic agents, symptom relief, and the patient-doctor relationship [3] [4] [5] . However, specific predisposing factors for treatment nonadherence in patients with psychiatric disorders is unknown. The
more » ... rs is unknown. The present study by Bosch et al. [6] focused on the quality of sleep as one of the factors that could help to explain treatment nonadherence in patients with schizophrenia or depression. Their findings show that in patients with schizophrenia, more severe negative symptoms and better quality of sleep was associated with better treatment adherence. By contrast, in patients with depression, symptom severity or quality of sleep was not associated with treatment adherence. The present study is noteworthy for its uncomplicated design with the use of well-established and standardized rating scales, making it easily replicated anywhere throughout the world. In addition, the merit of the current study findings can also be easily applied to actual clinical settings because all participants are outpatients of a clinic, at which most patients with schizophrenia and depression have been treated. However, as Bosch et al. [6] noted the study's findings must be interpreted carefully. For example, treatment adherence was measured by self-reported sleep logs. Although self-reporting is a convenient survey method, it can produce unreliable responses that are influenced by such factors as psychiatric symptoms, cognitive function, premorbid characteristics and pharmacological intervention, which may preclude
doi:10.20517/2347-8659.2018.14 fatcat:cyrjmx2fujdlneddopz5igkvmm