Attitude towards adherence in patients with schizophrenia at discharge.
BACKGROUND
Purpose of the present study was to assess the attitude towards adherence at discharge and to verify its predictability using anamnestic and sociodemographic variables, factors influencing clinical treatment as well as the medical treatment applied.


METHODS
Attitude towards adherence was evaluated in 369 inpatients with schizophrenic spectrum disorders within a naturalistic multicenter trial using the Compliance Rating Scale (CRS) by Kemp. Biweekly ratings of the PANSS, UKU and the Subjective Well-being under Neuroleptic Treatment Scale (SWN-K) were applied. Logistic regression and CART analyses were used to determine significant predictor variables for the attitude towards adherence at discharge.


RESULTS
Sixty-seven percent of the patients were rated to have an attitude of active participation and moderate participation (=positive attitude towards adherence) and 33% of the patients to have an attitude of passive acceptance, occasional or permanent reluctance towards treatment as well as refusing treatment (=negative attitude towards adherence). A significant correlation was found between patients with a positive attitude towards adherence and course of all PANSS subscales. Statistical analyses revealed a reduction in PANSS general psychopathology subscore, employment status, greater illness insight and treatment with atypical antipsychotics to be significantly predictive for a positive attitude towards adherence at discharge.


CONCLUSIONS
The importance of an adequate antipsychotic treatment as a precondition for a favourable adherence attitude and the need to incorporate adherence-focused psychotherapy and psychoeducation into daily clinical practice are highlighted.
Schennach-Wolff
Rebecca
R
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Nussbaumstr. 7, 80336 Munich, Germany. Rebecca.Schennach-Wolff@med.uni-muenchen.de
Jäger
Markus
M
Seemüller
Florian
F
Obermeier
Michael
M
Messer
Thomas
T
Laux
Gerd
G
Pfeiffer
Herbert
H
Naber
Dieter
D
Schmidt
Lutz G
LG
Gaebel
Wolfgang
W
Klosterkötter
Joachim
J
Heuser
Isabella
I
Maier
Wolfgang
W
Lemke
Matthias R
MR
Rüther
Eckart
E
Klingberg
Stefan
S
Gastpar
Markus
M
Möller
Hans-Jürgen
HJ
Riedel
Michael
M
D000328:Adult; D001294:Attitude to Health; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012559:Schizophrenia; D012565:Schizophrenic Psychology; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013997:Time Factors; D016903:Drug Monitoring