Caregivers’ Mental Health Literacy and Medication Adherence in Psychotic Disorders: A Cross-Sectional Study
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Objective: Adherence to antipsychotic medication is essential for the long-term management of psychotic disorders, yet non-adherence remains common. This study aimed to examine the association between caregivers’ mental health literacy (MHL) and patients’ medication adherence in a psychiatric outpatient setting in Baghdad, Iraq.
Methods and Materials: A descriptive cross-sectional correlational study was conducted from March to June 2025 at a specialized psychiatric center. A purposive sample of 150 primary caregivers of patients diagnosed with psychotic disorders was recruited. Data were collected using a demographic questionnaire, the Mental Health Literacy Scale (MHLS), and the Medication Adherence Rating Scale (MARS). Caregivers completed the MHLS to assess their literacy, while caregivers rated MARS items as proxy reports of patients’ adherence behavior. Data were analyzed using descriptive statistics, Spearman’s correlation, and linear regression (IBM SPSS 28).
Findings: Most caregivers (72.7%) had low MHL, and only 27.3% demonstrated high literacy. Regarding adherence, 36.0% of patients were classified as highly adherent, 56.7% as moderately adherent, and 7.3% as poorly adherent. A moderate, positive, and statistically significant correlation was observed between caregivers’ MHL and medication adherence (ρ = 0.490, p < 0.01). Regression analysis showed that MHL explained 26.2% of the variance in adherence scores (R² = 0.262).
Conclusion: Higher caregiver mental health literacy was associated with better medication adherence among patients with psychotic disorders, although the relationship was moderate and correlational. Integrating structured, culturally appropriate psychoeducation programs for caregivers into routine mental health services may help enhance literacy and support improved treatment continuity. Longitudinal and interventional studies are recommended to confirm causal pathways.
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