Key Takeaways

From the Authors As published in the article
  1. In patients with dissociative disorders, perceived benefits and barriers are the best indicators of treatment adherence; during sessions, therapists should purposefully emphasize treatment benefits.
  2. Adherence in dissociative patients may be greatly increased by addressing modifiable barriers, such as limited insight, stigma, logistical challenges, and inconsistent follow-up.
  3. When planning adherence-focused therapies, physicians should prioritize evaluating individual health beliefs rather than relying on patient characteristics because demographic factors do not consistently predict adherence.
Extended Takeaways
  1. In this sample, treatment engagement itself tracked closely with adherence: 55 of 83, 66.26%, of patients currently in therapy were in the high-adherence group, and 61 of 106, 57.54%, of those taking medication also showed higher adherence (P < .001 for both).
  2. The study used an evenly split comparison of 65 treatment-compliant and 65 treatment-noncompliant participants, which makes the observed differences in belief domains clinically easier to interpret at the point of care.
  3. Perceived benefit remained significant in multivariable testing (β=0.295, P =.001), suggesting that clinicians may gain more by directly testing whether patients expect therapy or medication to help than by focusing on illness seriousness alone.
  4. Perceived barriers showed a significant inverse association with adherence in both group comparisons (P=.007) and regression analysis (β=−1.633, P =.015), supporting routine screening for practical and psychosocial obstacles during follow-up.
  5. Severity- and risk-based messaging may have limited value for this population in isolation, because perceived severity and perceived susceptibility were not associated with compliance (P=1.0 for both), and cues to action were also nonsignificant (P=.216).
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Physicians Postgraduate Press, Inc. (PPP) makes no warranties about the accuracy or completeness of any information published in The Journal of Clinical Psychiatry or other PPP materials, and disclaims liability for any use or non-use of that information. Clinicians should not rely solely on these materials and should exercise their own professional judgment when making patient care decisions on an individualized basis.

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