Beyond the usual suspects: positive attitudes towards positive symptoms is associated with medication noncompliance in psychosis.


Autoria(s): Moritz S.; Favrod J.; Andreou C.; Morrison A.P.; Bohn F.; Veckenstedt R.; Tonn P.; Karow A.
Data(s)

2013

Resumo

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.

Identificador

http://serval.unil.ch/?id=serval:BIB_2F18A9E0784A

isbn:1745-1701 (Electronic)

pmid:22337789

doi:10.1093/schbul/sbs005

isiid:000320908900025

Idioma(s)

en

Direitos

info:eu-repo/semantics/openAccess

Fonte

Schizophrenia Bulletin, vol. 39, no. 4, pp. 917-922

Tipo

info:eu-repo/semantics/article

article