Srinivasan Tirupati N, Thara Rangaswamy
Schizophrenia Research Foundation, Chennai, India.
Schizophr Bull. 2002;28(3):531-5. doi: 10.1093/oxfordjournals.schbul.a006960.
Noncompliance with medication during a symptomatic phase is a common problem in the treatment of schizophrenia patients. In India, a majority of patients live with their families and those families supervise patients' medication intake. In a study of patients attending an urban outpatient care center in India, it was noted that when the patients were acutely ill and refused to take medication, the families administered medication to them without patients' knowledge, under the supervision of the psychiatrist. This method had been practiced by families in half the cases of patient noncompliance. Many families felt that there was no other viable alternative under the circumstances. Only a minority of patients was aware of having received medication through this method, and many of them reacted negatively to it. However, the patients were subsequently taking treatment voluntarily following the reduction in the severity of the behavioral disorder with the involuntary treatment. The issues involved in this form of treatment are discussed with regard to the social and health care environment in the country.
在精神分裂症患者的治疗中，症状期不遵医嘱服药是一个常见问题。在印度，大多数患者与家人同住，家人会监督患者服药。在一项针对印度一家城市门诊护理中心患者的研究中发现，当患者病情严重且拒绝服药时，家人会在精神科医生的监督下，在患者不知情的情况下给他们服药。在一半患者不遵医嘱的案例中，家人采用了这种方法。许多家庭认为在这种情况下没有其他可行的办法。只有少数患者意识到自己通过这种方式服过药，而且他们中的许多人对此反应消极。然而，随着行为障碍严重程度因非自愿治疗而减轻，患者随后自愿接受治疗。结合该国的社会和医疗保健环境，对这种治疗方式所涉及的问题进行了讨论。
