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Predictors of noncompliance in males with first-episode schizophrenia, schizophreniform and schizoaffective disorder

Published online by Cambridge University Press:  16 April 2020

Virginija Novak-Grubic*
Affiliation:
University Psychiatric Hospital, Studenec 48, SI-1260Ljubljana-Polje, Slovenia
Rok Tavcar
Affiliation:
University Psychiatric Hospital, Studenec 48, SI-1260Ljubljana-Polje, Slovenia
*
*Corresponding author. Tel.: +386-1-5872-149; fax: +386-1-5284-618. E-mail address: [email protected] (V. Novak-Grubic).
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Summary

Purpose

Many factors influencing compliance in schizophrenia have been reported in the literature. Our aim was to assess predictors of noncompliance in male patients with first-episode schizophrenia, schizophreniform and schizoaffective disorder in a naturalistic setting.

Subjects and methods

Fifty-six male patients, discharged from hospital, were included in a 1-year follow-up study. Psychopathological symptoms were assessed with positive and negative syndrome scale at admission and discharge, while extrapyramidal side effects were recorded weekly during hospitalisation using the Simpson–Angus and Barnes akathisia scales. Socio-demographic and some other variables were also recorded.

Results

Thirty patients (53.6%) dropped out of treatment in the first year and 21 of them relapsed. With the Cox survival analysis three predictors of noncompliance were found: diagnosis of schizophrenia versus the other two diagnoses, positive symptoms at admission, and lack of insight at discharge.

Discussion

In spite of a specific methodology and selection of only first-episode male patients, the results are in accordance with the findings of other authors. This confirms the universality of noncompliance in psychotic patients.

Conclusions

First-episode patients have a high dropout rate. However, in compliant patients, the relapse rate was low, and therefore special attention and compliance-promoting interventions in first-episode patients are needed.

Type
Original article
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS. 2002

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References

Albus, MBurkes, SScherer, JWhich factors modify drug-compliance? Psychiatr. Prax. 1995;22:228–30.Google ScholarPubMed
Amador, XFFlaum, MAndreasen, NCStrauss, DHYale, SAClark, SCet al. Awareness of illness in schizophrenia and schizoaffective and mood disorder. Arch. Gen. Psychiatry 1994; 51:826–36.CrossRefGoogle Scholar
Ayers, TLiberman, RPWallace, CJSubjective response to antipsychotic drugs: Failure to replicate predictions of outcome. J. Clin. Psychopharmacol. 1984;4:89–93.CrossRefGoogle Scholar
Barnes, TREA rating scale for drug induced akathisia. Br J Psychiatry 1989;154:672–6.CrossRefGoogle ScholarPubMed
Bartko, GHerczeg, IZador, GClinical symptomatology and drug compliance in schizophrenic patients. Acta Psychiatr. Scand. 1988;77:74–6.CrossRefGoogle ScholarPubMed
Buchanan, ACompliance with Treatment in Schizophrenia, Maudsley Monograph. London: Psychology Press; 1996.Google Scholar
Fenton, WSBlyler, CRHeinssen, RKDeterminants of medication compliance in schizophrenia: empirical and clinical findings. Schizophr. Bull. 1997;23:637–51.CrossRefGoogle ScholarPubMed
Fleischhacker, WWMeise, UGûnther, VKurz, MCompliance with antipsychotic drug treatment: influence of side effects. Acta Psychiatr. Scand. 1994;89(Suppl. 382):11–5.Google Scholar
Gaebel, WPietzcker, AOne year outcome of schizophrenic patients - the interaction of chronicity and neuroleptic treatment. Pharmacopsychiatry 1985;18:235–9.CrossRefGoogle ScholarPubMed
Garavan, JBrowne, SGervin, MLane, ALarkin, CO’Callaghan, ECompliance with neuroleptic medication in outpatients with schizophrenia; realationship to subjective response to neuroleptics; attitudes to medication and insight. Compr. Psychiatry 1998;39:215–9.CrossRefGoogle Scholar
Hoffmann, HAge and other factors relevant to the rehospital-ization of schizophrenic outpatients. Acta Psychiatr. Scand. 1994;89:205–10.CrossRefGoogle ScholarPubMed
Kay, SRFiszbein, AOpler, LAPositive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr. Bull. 1987;13: 261–76.CrossRefGoogle Scholar
Kissling, WCompliance, quality assurance and standards for relapse prevention in schizophrenia. Acta. Psychiatr. Scand. 1994;89(Suppl. 382):16–24.CrossRefGoogle Scholar
Kissling, WKane, JMBarnes, TREDencker, SJ Fleis-chhacker WW, Goldstein, MJet al. Guidelines for neuroleptic relapse prevention in schizophrenia: towards a consensus view. In: Kissling, W editor. Guidelines for Neuroleptic Relapse Prevention in Schizophrenia. Berlin: Springer Verlag; 1994. p. 155–63.Google Scholar
Kleinbaum, DGSurvival Analysis. New York: Springer-Verlag; 1997.Google Scholar
Lin, IFSpiga, RFortsch, WInsight and adherence to medication in chronic schizophrenics. J. Clin. Psychiatry 1979;40: 430–2.Google ScholarPubMed
Mayer, CSoyka, MCompliance bei der Therapie Schizophr-ener Patienten mit Neuroleptika - eine Übersicht. Fortschr. Neurol. Psychiatr 1992;60:217–22.CrossRefGoogle Scholar
Meltzer, HYOutcome in schizophrenia: beyond symptom reduction. J. Clin. Psychiatry 1999;60(suppl. 3):3–7.Google ScholarPubMed
Parker, GHadzi-Pavlovic, DThe capacity of a measure of disability (the LSP) to predict hospital readmission in those with schizophrenia. Psychol. Med. 1995;25:157–63.CrossRefGoogle ScholarPubMed
Piatkowska, OFarnill, DMedication - compliance or alliance? A client centred approach to increasing adherence. In: Cavanagh, DJ editor. Shizophrenia - An Overview and Practical Handbook. London: Chapman & Hall; 1992. p. 339–55.Google Scholar
Pristach, CASmith, CMMedication compliance and substance abuse among schizophrenic patients. Hosp Community Psychiatry 1990;41:1345–8.Google ScholarPubMed
Remington, GKapur, SZipursky, RBPharmacotherapy of first-episode schizophrenia. Br. J. Psychiatry 1998;172(suppl. 33):66–70.CrossRefGoogle ScholarPubMed
Robinson, DGWoerner, MGAlvir, JMJGeisler, SKoreen, ASheitman, Bet al. Predictors of relapse following response from a first episode of schizophrenia or schizoaffective disorder. Arch. Gen. Psychiatry 1999;56:241–7.CrossRefGoogle ScholarPubMed
Sellwood, WTarrier, NDemographic factors associated with extreme noncompliance in schizophrenia. Soc. Psychiatry Psychiatr. Epidemiol. 1994;29:172–7.Google Scholar
Seltzer, ARoncari, IGarfinkel, PEffect of patient education on medication compliance. Can. J. Psychiatry 1980;25:638–45.CrossRefGoogle ScholarPubMed
Shriqui, CLNeuroleptic dosing and neuroleptic plasma levels in schizophrenia: determining the optimal regimen. Can. J. Psychiatry 1995;40(Suppl. 2):38–48.CrossRefGoogle ScholarPubMed
Simpson, GMAngus, JWA rating scale for extrapyramidal side effects. Acta Psychiatr. Scand. 1970;45(Suppl. 212):11–9.CrossRefGoogle Scholar
Stip, EMemory impairment in schizophrenia: perspectives from psychopathology and pharmacotherapy. Can. J. Psychiatry 1996;41(Suppl. 2):27–34.CrossRefGoogle ScholarPubMed
Tavcar, RDernovsek, MZRecidivism in Slovenia. Psychiatr. Serv. 1997;48:955–6.Google ScholarPubMed
Tehrani, EKrussel, JBorg, LMunk-Jørgensen, PDropping out of psychiatric treatment: a prospective study of a first-admission cohort. Acta Psychiatr. Scand. 1996;94:266–71.CrossRefGoogle ScholarPubMed
Van Putten, TCrumpton, EYale, CDrug refusal in schizophrenia and the wish to be crazy. Arch. Gen. Psychiatry 1976;33: 1443–6.CrossRefGoogle ScholarPubMed
Vázquez-Barquero, JLCuesta, MJ Herrera Castanedo S, Lastra, IHerran, ADunn, GCantabria first-episode schizophrenia study: three-year follow-up. Br. J. Psychiatry 1999;174:141–9.CrossRefGoogle ScholarPubMed
World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders. Diagnostic Criteria for Research. Geneva: World Health Organisation; 1993.Google Scholar
Zvan, VNacela vzdrzevalne nevrolepticne terapije psihoz. Zdravstveno Varstvo 1989;28:335–41.Google Scholar
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