Association between Medication Adherence and Duration of Outpatient Treatment in Patients with Schizophrenia.

OBJECTIVE: Medication adherence is important in the treatment of schizophrenia, and critical periods during treatment may be associated with relapse. However, the relationship between adherence and duration of outpatient treatment (DOT) remains unclear. The authors aimed to clarify the relationship between adherence and DOT at a psychiatric hospital in Japan. METHODS: For outpatients with schizophrenia who regularly visit Shin-Abuyama hospital, the authors conducted a single questionnaire survey (five questions covering gender, age, DOT, medication shortages, and residual medication) over one month period. Participants were divided into two groups whether DOT were from more than one year to within five years or not. Mantel-Haenszel analysis and logistic regression analysis were performed on the data regarding the medication adherence. RESULTS: Effective answers were received for 328 patients. The residual medication rate was significantly higher among those receiving outpatient treatment from more than one year to within five years than five years than those receiving outpatient treatment for more than five years or less than one year (p=0.016). CONCLUSION: This survey suggests that there are critical periods during which patients are most prone to poor adherence. Because poor adherence increases the risk of relapse, specific measures must be taken to improve adherence during these periods.

Exceptionally long-lived luminescence emitted from Tb(III) ion caged in an Ag(I)-Tb(III)-thiacalix[4]arene supramolecular complex in water.

The compositions and photophysical properties of luminescent ternary complexes of thiacalix[4]arene-p-sulfonate (TCAS), Tb(III), and Ag(I) ions were determined. At pH 6, Ag(I) (2)Tb(III) (2)TCAS(2) formed. Moreover, at pH 10, in the presence of a 20-fold excess of Ag(I) and a 50-fold excess of TCAS with respect to Tb(III), Ag(I) (2)Tb(III)TCAS(2) formed as the main luminescent species. The structure of these complexes was proposed: two TCAS ligands are linked by two S-Ag(I)-S linkages to adopt a double-cone supramolecular structure. Furthermore, each Tb(III) ion in the former complex accepts O(-), S, O(-) donation, whereas in the latter, the Tb(III) center accepts eightfold O(-) donation. The luminescence quantum yield (Phi) of Ag(I) (2)Tb(III) (2)TCAS(2) (0.16) was almost equal to that of Tb(III)TCAS, but the luminescence lifetime tau of the former (=1.09 ms) was larger than that of the latter. For Ag(I) (2)Tb(III)TCAS(2), the yield Phi (=0.11) was small, which is attributed to the low efficiency of photosensitization (eta=0.11). However, the tau value (4.61 ms) was exceptionally large and almost equal to the natural luminescence lifetime of Tb(III) (4.7 ms), which is due to the absence of coordinating water molecules (q=0.1). This is compatible with the proposed structure in which the Tb(III) ion is shielded by a supramolecular cage that expels coordinated water molecules responsible for luminescence quenching.