Hostname: page-component-6bf8c574d5-h6jzd Total loading time: 0.001 Render date: 2025-02-25T13:04:00.076Z Has data issue: false hasContentIssue false
  • English
  • Français

A two-year prospective study of treatment compliance in patients with schizophrenia

Published online by Cambridge University Press:  09 July 2009

Alec Buchanan
Alec Buchanan*
Affiliation:
From the Maudsley Hospital, London
*
1 Address for correspondence: Dr Alec Buchanan, Maudsley Hospital, Denmark Hill, London SE5 8AZ.
Get access Rights & Permissions [Opens in a new window]

Synopsis

The study is a prospective investigation of the factors associated with treatment compliance in 61 patients discharged from hospital with a ward diagnosis of schizophrenia. All cases were classified using reliable diagnostic criteria and all were followed up for two years. Compliance was assessed by inspection of records and by analysis of urine. Sociodemographic factors and illness variables were unrelated to compliance. Some aspects of a patient's insight and attitude, namely, a belief that medication had helped during the admission, a stated willingness to take treatment after discharge and a generally optimistic outlook, were associated with improved compliance. Other variables which showed such an association were the absence of the drug side-effect akinesia, good previous compliance and voluntary, as opposed to compulsory, admission to hospital.

Type
Original Articles
Information
Psychological Medicine , Volume 22 , Issue 3 , August 1992 , pp. 787 - 797
Copyright
Copyright © Cambridge University Press 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Altman, H., Brown, M. L. & Sletten, I. W. (1972 a). ‘And…silently steal away’:a study of elopers. Diseases of the Nervous System 33, 52–58.Google Scholar
Altman, H., Angle, H. V., Brown, M. L. & Sletten, I. W. (1972 b). Prediction of unauthorised absence. American Journal of Psychiatry 128, 1460–1463.CrossRefGoogle Scholar
Baekeland, F. & Lundwall, L. (1975). Dropping out of treatment: a critical review. Psychological Bulletin 82, 735–783.CrossRefGoogle ScholarPubMed
Bartko, G., Herczeg, I. & Zador, G. (1988). Clinical symptomatology and drug compliance in schizophrenic patients. Acta Psychiatrica Scandinavica 77, 74–76.CrossRefGoogle ScholarPubMed
Baum, O. E., Felzer, S. B., D'Zmura, T. L. & Shumaker, E. (1966). Psychotherapy, dropouts and lower socioeconomic patients. American Journal of Orthopsychiatry 36, 629–635.Google Scholar
Brand, F., Smith, R. & Brand, P. (1977). Effect of economic barriers to medical care on patient's non-compliance. Public Health Reports 92, 72–78.Google Scholar
Burgoyne, R. W. (1976). Effect of drug ritual changes on schizophrenic patients. American Journal of Psychiatry 133, 284–289.Google ScholarPubMed
Crawford, R. & Forrest, A. (1974). Controlled trial of depot fluphenazine in out-patient schizophrenics. British Journal of Psychiatry 124, 385–391.CrossRefGoogle ScholarPubMed
Davis, M. S. (1966). Variations in patients' compliance with doctors' orders: analysis of congruence between survey responses and results of empirical observations. Journal of Medical Education 41, 1037–1048.Google Scholar
Davis, K. L., Estess, F. M., Simonton, S. C. & Gonda, T. A. (1977). Effects of payment mode on clinic attendance and rehospitalization. American Journal of Psychiatry 134, 576–578.Google Scholar
Dinnen, A. (1971). Change of therapists as a cause of absences from group psychotherapy. British Journal of Psychiatry 119, 625–628.CrossRefGoogle ScholarPubMed
Dodd, J. A. (1971). A retrospective analysis of variables related to duration of treatment in a university psychiatric clinic. Journal of Nervous and Mental Disease 151, 75–85.CrossRefGoogle Scholar
Eisenthal, S., Emery, R., Lazare, A. & Udin, H. (1979). ‘Adherence’ and the negotiated approach to patienthood. Archives of General Psychiatry 36, 393–398.CrossRefGoogle ScholarPubMed
Falloon, I. R. H. (1984). Developing and maintaining adherence to long-term drug-taking regimens. Schizophrenia Bulletin 10, 412–417.CrossRefGoogle ScholarPubMed
Falloon, I., Watt, D. C. & Shepherd, M. (1978). A comparative controlled trial of pimozide and fluphenazine decanoate in the continuation therapy of schizophrenia. Psychological Medicine 8, 59–70.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975). ‘Mini – mental state’. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189–198.CrossRefGoogle Scholar
Frank, J. D., Gliedman, L. H., Imber, S. D., Nash, E. H. & Stone, A. R. (1957). Why patients leave psychotherapy. Archives of Neurology and Psychiatry 77, 283–299.CrossRefGoogle ScholarPubMed
Freeman, H. (1973). Long acting neuroleptics and their place in the community mental health services in the United Kingdom. In The Future of Pharmacotherapy: New Drug Delivery Systems (ed. Ayd, F. J.), pp. 37–42. International Drug Therapy Newsletter: Baltimore.Google Scholar
Goldberg, S. C., Schooler, N. R.Hogarty, G. E. & Roper, M. (1977). Prediction of relapse in schizophrenic out-patients treated by drug and sociotherapy. Archives of General Psychiatry 34, 171–184.CrossRefGoogle ScholarPubMed
Greenwald, A. F. & Bartemeier, L. H. (1963). Psychiatric discharges against medical advice. Archives of General Psychiatry 8, 117–119.Google Scholar
Hare, E. H. & Willcox, D R. C. (1967). Do psychiatric inpatients take their pills? British Journal of Psychiatry 113, 1435–1439.Google Scholar
Hogan, T. P., Awad, A. G. & Eastwood, R. (1983). A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity. Psychological Medicine 13, 177–183.CrossRefGoogle ScholarPubMed
Howard, K., Rickels, K., Mock, J. E., Lipman, R. S., Covi, L. & Bauman, N. C. (1970). Therapeutic style and attrition rate from psychiatric drug treatment. Journal of Nervous and Mental Disease 150, 102–110.CrossRefGoogle ScholarPubMed
Irwin, D. S., Weitzel, W. D. & Morgan, D. W. (1971). Phenothiazine intake and staff attitudes. American Journal of Psychiatry 127, 1631–1635.CrossRefGoogle ScholarPubMed
Johnson, D. A. W. & Freeman, H. (1972). Long acting tranquillisers. Practitioner 208, 395–400.Google Scholar
Joyce, C. R. B., Caple, G., Mason, M., Reynolds, E. & Mathews, J. A. (1969). Quantitative study of doctor-patient communication. Quarterly Journal of Medicine 38, 183–194.Google ScholarPubMed
Katz, J. & Solomon, R. Z. (1958). The patient and his experiences in an out-patient clinic. Archives of Neurology and Psychiatry 80, 86–92.Google Scholar
Ley, P. & Morris, L. (1984). Psychological aspects of written information for patients. In Contributions to Medical Psychology vol. 3 (ed. Rachman, S.), pp. 117–149. Pergamon Press: Oxford.Google Scholar
Ley, P. & Spelman, M. S. (1965). Communications in an out-patient setting. British Journal of Social and Clinical Psychology 4, 114–116.CrossRefGoogle Scholar
Lin, I. F., Spiga, R. & Fortsch, W. (1979). Insight and adherence to medication in chronic schizophrenics. Journal of Clinical Psychiatry 40, 430–432.Google ScholarPubMed
McGlashan, T. H. & Carpenter, W. T. (1981). Does attitude toward psychosis relate to outcome? American Journal of Psychiatry 138, 797–801.Google ScholarPubMed
Marder, S. R., Mebane, A., Chien, C. P., Winslade, W. J., Swann, E. & Van Putten, T. (1983). A comparison of patients who refuse and consent to neuroleptic treatment. American Journal of Psychiatry 140, 470–472.Google ScholarPubMed
Mazzullo, J. V., Lasagna, L. & Grinar, P. F., (1974). Variations in interpretation of clinic instructions: the need for improved prescribing habits. Journal of the American Medical Association 227, 929–931.CrossRefGoogle Scholar
Meichenbaum, D. & Turk, D. (1987). Facilitating Treatment Adherence: A Practitioner's Guidebook. Plenum: New York.Google Scholar
Mozdzierz, G. J., Macchitelli, F. J., Conway, J. A. & Krauss, H. H. (1973). Personality characteristic differences between alcoholics who leave treatment against medical advice and those who don't. Journal of Clinical Psychology 29, 78–82.3.0.CO;2-0>CrossRefGoogle ScholarPubMed
Myers, E. D. (1975). Age, persistence and improvement in an out-patient group. British Journal of Psychiatry 127, 157–159.CrossRefGoogle Scholar
Nelson, A. (1975). Drug default among schizophrenic patients. American Journal of Hospital Pharmacy 32, 1237–1242.Google Scholar
Parkes, C. M., Brown, G. W. & Monck, E. M. (1962). The general practitioner and the schizophrenic patient. British Medical Journal i, 972–976.Google Scholar
Parkin, D. M., Henney, C. R., Quirk, J. & Crooks, J. (1976). Deviation from prescribed drug treatment after discharge from hospital. British Medical Journal, ii, 686–687.CrossRefGoogle Scholar
Pisani, V. D. & Motansky, G. U. (1970). Predictors of premature termination of outpatient followup group psychotherapy among male alcoholics. International Journal of the Addictions 5, 731–737.CrossRefGoogle ScholarPubMed
Raynes, A. E. & Patch, V. D. (1971). Distinguishing features of patients who discharge themselves from a psychiatric ward. Comprehensive Psychiatry 12, 473–479.CrossRefGoogle Scholar
Renton, C. A., Affleck, J. W., Carstairs, G. M. & Forrest, A. D. (1963). A follow-up of schizophrenic patients in Edinburgh. Acta Psychiatrica Scandinavica 39, 548–581.CrossRefGoogle ScholarPubMed
Rosenberg, C. M., Davidson, G. E. &Patch, V. D. (1972). Dropouts from a methadone program for addicts. International Journal of Addictions 7, 415–425.CrossRefGoogle ScholarPubMed
Royal Statistical Society (1986). The GLIM System, Release 3.77. Numerical Algorithms Group: Oxford.Google Scholar
Soskis, D. A. (1978). Schizophrenic and medical in-patients as informed drug consumers. Archives of General Psychiatry 35, 645–649.CrossRefGoogle Scholar
Soskis, D. A. & Bowers, M. B. (1969). The schizophrenic experience. Journal of Nervous and Mental Disease 149, 443–449.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Endicott, J., Gibson, M. & Robins, E. (1978). Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry 35, 773–782.Google Scholar
Van Putten, T. (1974). Why do schizophrenic patients refuse to take their drugs? Archives of General Psychiatry 31, 67–72.Google Scholar
Van Putten, T., Crumpton, E. & Yale, C. (1976). Drug refusal in schizophrenia and the wish to be crazy. Archives of General Psychiatry 33, 1443–1445.Google Scholar
Willcox, D. R., Gillan, R. & Hare, E. H. (1965). Do psychiatric out-patients take their drugs? British Medical Journal ii, 790–792.CrossRefGoogle Scholar
Wilson, J. D. & Enoch, M. D. (1967). Estimation of drug rejection by schizophrenic in-patients, with analysis of clinical factors. British Journal of Psychiatry 113, 209–211.Google Scholar
Winkelman, N. W. (1964). A clinical and socio-cultural study of 200 psychiatric patients started on chlorpromazine 10·5 years ago. American Journal of Psychiatry 120, 861–869.CrossRefGoogle Scholar