The purpose of this study is to determine whether Medication Adherence Therapy (MAT) can significantly improve medication adherence and lower the risk of rehospitalization in older patients with psychosis. A secondary goal is to identify risk factors for nonadherence and determine whether MAT has benefits that extend beyond adherence and hospitalization.

Psychoses are among the most common and serious psychiatric disorders. Currently, the most effective treatment for psychoses involves the use of antipsychotic or neuroleptic medications. Unfortunately, pharmacologic regimens often do not achieve their goals because of poor medication adherence. Nonadherence to antipsychotic treatment is a considerable public health problem that leads to myriad clinical and economic burdens, including psychotic relapse, increased clinic and emergency room visits, and rehospitalization.

Participants in this study are randomly assigned to receive either MAT or supportive treatment for 12 weeks. MAT is given in 15 sessions and consists of motivational interviewing, education, and social skills and behavior modification. Individual MAT sessions are held in Weeks 1 and 12; small group sessions take place in Weeks 2 through 11. Three monthly booster group sessions begin in Week 16. Participants are assessed at baseline and at 3, 6, and 12 months. Medication adherence, psychopathology, quality of life, medication side effects, health beliefs, and functioning are assessed.

Ages Eligible for Study:  45 Years and above,  Genders Eligible for Study:  Both

Criteria

Inclusion Criteria:

• DSM-IV criteria for schizophrenia or schizoaffective disorder
• Outpatient status at the time of enrollment
• Currently prescribed maintenance treatment with antipsychotic medication (typical or atypical, oral or depot)