Document Detail

Beyond the usual suspects: positive attitudes towards positive symptoms is associated with medication noncompliance in psychosis.
MedLine Citation:
PMID:  22337789     Owner:  NLM     Status:  MEDLINE    
Antipsychotic medication represents the treatment of choice in psychosis according to clinical guidelines. Nevertheless, studies show that half to almost three-quarter of all patients discontinue medication with antipsychotics after some time, a fact which is traditionally ascribed to side-effects, mistrust against the clinician and poor illness insight. The present study investigated whether positive attitudes toward psychotic symptoms (ie, gain from illness) represent a further factor for medication noncompliance. An anonymous online survey was set up in order to prevent conservative response biases that likely emerge in a clinical setting. Following an iterative selection process, data from a total of 113 patients with a likely diagnosis of schizophrenia and a history of antipsychotic treatment were retained for the final analyses (80%). While side-effect profile and mistrust emerged as the most frequent reasons for drug discontinuation, 28% of the sample reported gain from illness (eg, missing voices, feeling of power) as a motive for noncompliance. At least every fourth patient reported the following reasons: stigma (31%), mistrust against the physician/therapist (31%), and rejection of medication in general (28%). Approximately every fifth patient had discontinued antipsychotic treatment because of forgetfulness. On average, patients provided 4 different explanations for noncompliance. Ambivalence toward symptoms and treatment should thoroughly be considered when planning treatment in psychosis. While antipsychotic medication represents the evidence-based cornerstone of the current treatment in schizophrenia, further research is needed on nonpharmacological interventions for noncompliant patients who are willing to undergo intervention but refuse pharmacotherapy.
Steffen Moritz; Jerome Favrod; Christina Andreou; Anthony P Morrison; Francesca Bohn; Ruth Veckenstedt; Peter Tonn; Anne Karow
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Publication Detail:
Type:  Journal Article     Date:  2012-02-15
Journal Detail:
Title:  Schizophrenia bulletin     Volume:  39     ISSN:  1745-1701     ISO Abbreviation:  Schizophr Bull     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-06-20     Completed Date:  2014-02-14     Revised Date:  2014-07-02    
Medline Journal Info:
Nlm Unique ID:  0236760     Medline TA:  Schizophr Bull     Country:  United States    
Other Details:
Languages:  eng     Pagination:  917-22     Citation Subset:  IM    
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MeSH Terms
Antipsychotic Agents / therapeutic use*
Attitude to Health*
Logistic Models
Medication Adherence / psychology*
Middle Aged
Psychotic Disorders / drug therapy*,  psychology
Schizophrenia / drug therapy*
Schizophrenic Psychology*
Reg. No./Substance:
0/Antipsychotic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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