Compliance therapy in psychotic patients: randomised controlled trial.
OBJECTIVE
To determine whether compliance therapy, a cognitive-behavioural intervention, could improve compliance with treatment and hence social adjustment in acutely psychotic inpatients, and if so, whether the effect persisted six months later.


METHODS
Randomised controlled trial of compliance therapy and non-specific counselling, each comprising 4-6 sessions lasting 10-60 minutes.


METHODS
Acute psychiatric admissions ward serving an inner London catchment area.


METHODS
47 patients with psychosis.


METHODS
Informant and observer reported measure of compliance; observer assessed global functioning after intervention and three and six months later; self-rated attitudes to drug treatment after the intervention and one month later; symptom scores after intervention and six months later.


RESULTS
25 patients received compliance therapy and showed significantly greater improvements in their attitudes to drug treatment and in their insight into illness and compliance with treatment compared with the control group. These gains persisted for six months. The intervention group was 5.2 times more likely than the control group to reach a criterion level of compliance (95% confidence interval 1.5 to 18.3). Global functioning showed a tendency to improve more in the intervention group after a delay (odds ratio 3.0 (0.8 to 11.5) to reach the criterion level at six months). Four subjects given compliance therapy and six in the control group were readmitted during follow up (odds ratio 2.0 (0.48 to 8.2)).


CONCLUSIONS
Compliance therapy is a pragmatic method for improving compliance with drug treatment in psychotic inpatients and its gains persist for at least six months. Overall functioning may also be enhanced.
Kemp
R
R
Department of Psychological Medicine, King's College Hospital, London.
Hayward
P
P
Applewhaite
G
G
Everitt
B
B
David
A
A
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003376:Counseling; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011618:Psychotic Disorders / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome