Grant: Doctoral Research Award: Canada Graduate Scholarships

Schizophrenia (SCZ) is a chronic mental disorder that affects more than 20 million people worldwide. People with SCZ experience psychosis and impaired cognition. Antipsychotic medication adherence is critical to SCZ treatment. Studies suggest 33-44% of patients with first-episode SCZ spectrum disorder (FES) become nonadherent within 6-months of treatment initiation with more than 60% of them discontinuing their medication. Medication nonadherence is not only associated with worsening symptoms, but also increased rates of hospitalization and suicide. A major predictor of medication nonadherence in patients with SCZ is impaired insight, involving having partial or no conscious awareness of one's illness, symptoms, and need for treatment. There are no established interventions to improve treatment adherence in patients with FES so far, calling for the need to develop innovative methods. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that has been shown to be effective as an adjunctive treatment for various brain disorders, including a recent RCT that showed tDCS improves insight in SCZ. tDCS selectively alters brain function by delivering a weak electric current via electrodes placed on the scalp. The proposed study employs a novel approach to investigate the effects of adjunctive tDCS on antipsychotic medication adherence. Participants will receive twice-daily tDCS for 10 days (20 sessions). Brain scans will be performed before and after 10 days of tDCS. Antipsychotic drug adherence will be assessed monthly based primarily on pill-count, and secondarily plasma level concentrations. Positive results will indicate that tDCS has the potential to alter patient attitudes toward their illness and treatment, in turn, improving medication adherence, clinical outcomes, and the well-being of individuals with FES and their families. Undoubtedly, this would have a critical impact on the management of this devastating mental illness.