Clinical and Psychosocial Predictors of Medication Adherence among Patients with Bipolar Disorder: a Cross-Sectional Analytical Study

Abstract

Background: The critical role of medication adherence in preventing relapses and better clinical outcomes is emphasized in the treatment of BD. Adherence to medication is crucial in preventing relapses and in achieving better clinical outcomes in BD. Non-adherence is still a major problem though, with many clinical and psychosocial factors.

Objective: To determine clinical and psychosocial factors predicting adherence to medication treatment in individuals with BD.

Place and Duration of Study: The study was carried out in the Psychiatry Department of Punjab Institute of Mental Health ( PIMH), Lahore from March 2025 to August 2025.

Methods: A cross-sectional analytical study was carried out with 150 patients with a diagnosis of BD. The WHO sample size formula was used to determine the sample size. The data were gathered by using a structured questionnaire, which included demographic characteristics, clinical factors, psychosocial variables and the Medication Adherence Rating Scale (MARS) to measure medication adherence. A statistical analysis was conducted to identify predictors of adherence that are significant.

Results: The 150 who participated in this study included 58% with good adherence and 42% with poor adherence to the medication. Increased illness insight, high family supportive factors, positive medication attitudes and frequent psychiatric follow-up emerged as significant factors associated with the adherence. Significant predictors of non-adherence identified were poor insight, side effects of medication, substance use, and the perceived stigma.

Conclusion: There are clinical and social factors that affect adherence to medications (MD) in BD. Psychoeducation, family engagement, and better patient–provider communication could potentially improve adherence to treatment, which could be achieved by addressing these determinants.