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Psychopathology, insight and compliance in schizophrenia

Published online by Cambridge University Press:  13 June 2014

Vikrant Bajaj*
Affiliation:
Department of Psychiatry, Institute of Human Behaviour and Allied Sciences (IHBAS), 6C, Pocket A, Dilshad Garden, Delhi 110095, India
Somnath Sengupta
Affiliation:
Department of Psychiatry, Institute of Human Behaviour and Allied Sciences (IHBAS), Dilshad Garden, Delhi 110095, India
Dhanesh Kumar Gupta
Affiliation:
Department of Psychiatry, Institute of Human Behaviour and Allied Sciences (IHBAS), Dilshad Garden, Delhi 110095, India
*
*Correspondence Email: [email protected]

Abstraact

Objective: A four-week longitudinal study was conducted to assess the relationship between insight, psychopathology and treatment compliance in schizophrenia.

Method: The study was conducted using Insight and Treatment Attitude Questionnaire (ITAQ), Positive and Negative Syndrome Scale (PANSS) and Medication Adherence Rating Scale (MARS). The sample comprised 50 patients with schizophrenia diagnosed according to research criteria of the International Classification of Diseases (ICD-10), with a mean duration of illness of 5.32 years.

Results: Substantial psychopathology was observed at intake and it improved significantly at the end of four weeks. Similar changes were observed in the score of insight and of compliance over four weeks. The insight and the compliance were positively correlated to each other at the beginning and at the end of four weeks. Both of these were negatively correlated with psychopathology scores on both occasions.

Conclusion: Insight and psychopathology remain important determinants of treatment compliance in schizophrenia over short term and long term follow up.

Type
Original Papers
Copyright
Copyright © Cambridge University Press 2009

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References

1.Fenton, WS, Blyler, CR. Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schiz Bull 1997; 23(4): 637651.CrossRefGoogle ScholarPubMed
2.Robinson, D, Woerner, MG. Predictors of relapse following response from a first episode of schizophrenia or schizoaffective disorder. Arch Gen Psychiatry 1999; 56: 241247.CrossRefGoogle ScholarPubMed
3.Jeffreys, SE, Harvey, CA. The Hampstead Schizophrenia Survey 1991: prevalence and service use comparisons in an inner London health authority, 1986-1991. Br J Psychiatry 1997; 170: 301306.CrossRefGoogle Scholar
4.Adams, J, Scott, J. Predicting medication adherence in severe mental disorders. Acta Psychiatr Scand 2000; 101: 119124.CrossRefGoogle ScholarPubMed
5.McCabe, R, Quayle, E. Is there a role for compliance in the assessment of insight in chronic schizophrenia? Psychology, health and medicine 2000; 5(2):173178.Google Scholar
6.McEvoy, JP, Freter, S. Insight and clinical outcome of schizophrenic patients. J Nerv MentDis 1989; 177:4851.CrossRefGoogle ScholarPubMed
7.Cuffel, BJ, Alford, J. Awareness of illness in schizophrenia and outpatient treatment adherence. J Ner Ment Dis 1996; 184(11): 653659.CrossRefGoogle ScholarPubMed
8.Rittmannsberger, H, Pachinger, T. Medication adherence among psychotic patients before admission to inpatient treatment. Psychiatr Serv 2004; 55: 174179.CrossRefGoogle ScholarPubMed
9.Marder, SR, Mebane, A. A comparison of patients who refuse and consent to neuroleptic treatment. Am J Psychiatry 1983;140: 470472.Google ScholarPubMed
10.Verdoux, H, Lengronne, J. Medication adherence in psychosis: predictors and impact on outcome. A 2 year follow up of first admitted subjects. Acta Psychiatr Scand 2000; 102:203210Google ScholarPubMed
11.David, A, Buchanan, A, Reed, A. The assessment of insight in psychosis. Br J Psychiatry 1992; 161: 599602.CrossRefGoogle ScholarPubMed
12.World Health Organization. The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. Geneva, World Health Organization, 1992.Google Scholar
13.McEvoy, JP, Apperson, IJ. Insight in schizophrenia: its relationship to acute psychopathology. J Nerv Ment Dis 1989; 177: 4347.CrossRefGoogle ScholarPubMed
14.Kay, SR, Fiszbein, A, Opler, LA. The positive and negative syndrome scale for schizophrenia. Schizophr Bull 1987; 13: 261276.CrossRefGoogle ScholarPubMed
15.Thompson, K, Kulkarni, J. Reliability and validity of a new medication adherence rating scale for the psychoses. Schizophr Res 2000; 102: 241247.CrossRefGoogle Scholar
16.Kulhara, P, Chakravarty, S, Basu, D. Insight and psychosis: An empirical enquiry. Ind J Soc Psychiatry 1992; 8: 4044.Google Scholar
17.Trauer, T, Sacks, T. The relationship between insight and medication adherence in severely mentally ill clients treated in community. Acta Psychiatr Scand 2000; 102: 211216.CrossRefGoogle Scholar
18.Lincoln, AKP, Chandrasekharan, R. Insight, psychopathology and schizophrenia. Ind J Psychiatry 2002; 44(4): 332336.Google Scholar
19.Heinrichs, DW, Cohen, BP, Carpenter, WT. Early insight and the management of schizophrenic decompensation. J Nerv Ment Dis 1985; 173(3): 133138.CrossRefGoogle ScholarPubMed
20.Amador, XF, Strauss, DH. The assessment of insight in psychosis. Am J Psychiatry 1993; 150:873879.Google ScholarPubMed
21.Cuesta, MJ, Peralta, V. Lack of insight in schizophrenia. Schizophr Bull 1994; 20(2): 359366.CrossRefGoogle ScholarPubMed
22.Aga, VM, Agarwal, AK, Gupta, SC. The relationship of insight to psychopathology in schizophrenia. Ind J Psychiatry 1995; 37(3): 129135.Google ScholarPubMed
23.Tattan, TMG, Creed, FH. Negative symptoms of schizophrenia and compliance with medication. Schizophr Bull 2001; 27(1): 149155.CrossRefGoogle ScholarPubMed
24.Mehrotra, S, Sengupta, SN. Insight and psychopathology in schizophrenia: A four week longitudinal study. German J Psychiatry 2005; 8: 4852.Google Scholar
25.Lin, IF, Spiga, R. Insight and adherence to medication in chronic schizophrenia. J Clin Psychiatry 1979; 40(10): 430432.Google Scholar
26.Tharyan, A, Saravanan, B. Insight and psychopathology in schizophrenia. Ind J Psychiatry 2000; 42(4): 421426.Google ScholarPubMed
27.Saravanan, B, Jacob, KS. Assessing insight in schizophrenia: East meets west. Br J Psychiatry 2007; 190: 243247.CrossRefGoogle ScholarPubMed
28.Bartko, G, Hertzeg, I, Zador, G. Clinical symptomatology and drug compliance in schizophrenic patients. Acta Psychiatr Scand 1988; 77: 7476.CrossRefGoogle ScholarPubMed
29.Dervaux, A, Bayle, FJ, Laqueille, Xet al.Nicotine use in schizophrenia and disinhibition. Psychiatry Res 2004; 128(3): 229234.CrossRefGoogle ScholarPubMed