Compliance in schizophrenia: psychopathology, side effects, and patients' attitudes toward the illness and medication.
OBJECTIVE
In a cross-sectional study, we investigated the influence of several factors on compliance in schizophrenia outpatients, including patients' attitudes toward the illness and medication, specifically antipsychotic medication; adverse effects; and attitudes of caregivers and relatives toward the illness and medication.


METHODS
Patients suffering from schizophrenia (ICD-10 diagnosis) of at least 1-year's duration whose discharge from an inpatient ward was at least 6 weeks prior to inclusion in the study were investigated. Study instruments included a semi-structured compliance interview, the Positive and Negative Syndrome Scale, the Udvalg for Klinske Undersogelser Side Effect Rating Scale, the St. Hans Rating Scale, and the Hillside Akathisia Scale. Data were collected from May 1998 to December 2001.


RESULTS
52.5% (N = 32) of the 61 investigated patients were fully compliant, 39.3% (N = 24) were partially compliant, and only 8.2% (N = 5) were noncompliant. We found positive correlations between compliance and the patients' feelings of a positive effect of the drug on the illness, between compliance and negative symptoms, and between compliance and antipsychotic-induced psychological side effects.


CONCLUSIONS
Our findings reemphasize the importance of taking subjective attitudes and concerns of patients with respect to their illness and medication seriously. Therefore, it is indispensable to include patients and, if possible, their relatives in the treatment decision process to enhance medication compliance in schizophrenia patients.
Rettenbacher
Maria A
MA
Department of Biological Psychiatry, Innsbruck University Clinics, Innsbruck, Austria. maria.rettenbacher@uibk.ac.at
Hofer
Alex
A
Eder
Ursula
U
Hummer
Martina
M
Kemmler
Georg
G
Weiss
Elisabeth M
EM
Fleischhacker
Wolfgang W
WW
D000328:Adult; D000553:Ambulatory Care; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001294:Attitude to Health; D001480:Basal Ganglia Diseases / Q000139:chemically induced / Q000523:psychology; D017028:Caregivers / Q000523:psychology; D003430:Cross-Sectional Studies; D005192:Family Health; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D010349:Patient Compliance; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D012737:Sex Factors
D014150:Antipsychotic Agents