Cannabis use and involuntary admission may mediate long-term adherence in first-episode psychosis patients: a prospective longitudinal study

Background: This study aimed to examine factors associated with treatment adherence in first-episode psychosis (FEP) patients followed up over 8 years, especially involuntary first admission and stopping cannabis use. Methods: This prospective, longitudinal study of FEP patients collected data on symptoms, adherence, functioning,and substance use. Adherence to treatment was the main outcome variable and was categorized as ‘good’ or ‘bad’. Cannabis use during follow-up was stratified as continued use, stopped use, and never used. Bivariate and logistic regression models identified factors significantly associated with adherence and changes in adherence over the 8-year follow-up period. Results: Of the 98 FEP patients analyzed at baseline, 57.1% had involuntary first admission, 74.4% bad adherence,and 52% cannabis use. Good adherence at baseline was associated with Global Assessment of Functioning score (p = 0.019), Hamilton Depression Rating Scale score (p = 0.017) and voluntary admission (p < 0.001). Adherence patterns over 8 years included: 43.4% patients always bad, 26.1% always good, 25% improved from bad to good. Among the improved adherence group, 95.7% had involuntary first admission and 38.9% stopped cannabis use. In the subgroup of patients with bad adherence at baseline, involuntary first admission and quitting cannabis use during follow up were associated with improved adherence. Conclusions: The long-term association between treatment adherence and type of first admission and cannabis use in FEP patients suggest targets for intervention to improve clinical outcomes.

Linking transformational leadership and organizational trust: has organizational commitment a mediating effect on it?

[EN] The main goal of this study is to analyze how organizational commitment has a mediating effect on the relation between transformational leadership and organizational trust. Therefore we developed an organization analysis based on a survey that was used to collect primary data from a sample of 58 employees. We obtained a 71% response rate and these data were analyzed using quantitative methodological techniques and linear regression. The research was conducted at the Serralves Foundation (Porto, Portugal) to empirically test the proposed research model and its hypotheses. The empirical results confirm that transformational leadership positively enhances organizational trust. However, transformational leadership and organizational trust are not significantly influenced by organizational commitment, thus not having a mediating effect on this relationship. Such results assume particular relevance because they become a basis for comparative studies in similar organizations. This study brings some theoretical contributions to the literature by analyzing the mediating effect of organizational commitment on the relation between transformational leadership and organizational trust in cultural organizations and has also some practical management implications, as it draws attention to the importance of a set of practices, job satisfaction oriented, which can effectively lead to organizational commitment intervention in the relationship between transformational leadership and organizational trust.