Novak-Grubic Virginija, Tavcar Rok
University Psychiatric Hospital, Studenec 48, SI-1260 Ljubljana-Polje, Slovenia.
Eur Psychiatry. 2002 May;17(3):148-54. doi: 10.1016/s0924-9338(02)00645-4.
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.
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.
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.
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.
文献中已报道了许多影响精神分裂症患者依从性的因素。我们的目的是在自然环境中评估首次发作的精神分裂症、精神分裂症样障碍和分裂情感性障碍男性患者不依从的预测因素。
56名出院的男性患者纳入了一项为期1年的随访研究。入院和出院时用阳性和阴性症状量表评估精神病理症状，住院期间每周用辛普森-安格斯量表和巴恩斯静坐不能量表记录锥体外系副作用。还记录了社会人口学和其他一些变量。
30名患者（53.6%）在第一年退出治疗，其中21人复发。通过Cox生存分析发现了三个不依从的预测因素：精神分裂症诊断与其他两种诊断相比、入院时的阳性症状以及出院时缺乏自知力。讨论。尽管采用了特定的方法且仅选择首次发作的男性患者，但结果与其他作者的发现一致。这证实了精神病患者不依从的普遍性。
首次发作患者的退出率很高。然而，依从性好的患者复发率低，因此首次发作患者需要特别关注和促进依从性的干预措施。
