Medication adherence is a matter of relevance for early treatment of psychotic disorder.

To understand pattern of medication adherence in this population and factors influencing.

To understand the antipsychotic adherence pattern in early stages of psychotic disorder and to identify factors that influence.

Natural observation study of 136 patients of first-episode psychosis presenting to Early intervention service in multicultural South London. Data derived from case notes and interviews using standard rating scales for first 18 months.

Only 39% of patients (n=50) were 100% time adherent with antipsychotic medication in the first month (rest were 83%). Patients using illicit substances were less likely 100% adherent (Pearson χ2= 13.1, df=1,p=0.001). Caucasian patients were more likely to be fully adherent in the first month than Ethnic minority patients (Pearson χ2= 7.5, df=1, p=0.009). During the follow-up period about 57% patients had weeks of not taking antipsychotic, mostly after recovery from first episode. Ethnicity (Pearson χ2=4.5, df=1, p=0.05) and experience of extrapyramidal side-effect (Pearson χ2= 5.6, df=1, p=0.02) were associated with this gap. Involvement of a carer in treatment was associated with better (100%) adherence during follow-up (Pearson χ2= 4.9, df=1,p=0.03).

Interventions in early stages of psychosis should focus on therapies involving carers/ families and giving attention to illicit substances use and delivered in way relevant to the local ethnic population. Also antipsychotics chosen carefully, using a lower dose and actively looking for emergence of side-effects.