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精神分裂症患者依从或不依从抗精神病药物治疗的主观原因。

Schizophrenic patients' subjective reasons for compliance and noncompliance with neuroleptic treatment.

作者信息

Löffler W, Kilian R, Toumi M, Angermeyer M C

机构信息

Universtity of Leipzig, Department of Psychiatry, Leipzig, Germany.

出版信息

Pharmacopsychiatry. 2003 May;36(3):105-12. doi: 10.1055/s-2003-39985.

Abstract

Although several factors influencing schizophrenic patients' compliance with neuroleptic treatment have been investigated, the subjective reasons that patients are willing or reluctant to take medication have rarely been examined. In a follow-up study of a sample of schizophrenic patients currently undergoing psychiatric treatment in the city of Leipzig, 307 patients were asked about their subjective reasons for medication compliance or noncompliance by administering the Rating of Medication Influences (ROMI) Scale. The perceived benefit from medication proved to be the main reason for patients' compliance with neuroleptic treatment. Respectively, patient-reported noncompliance was mainly explained by negative side effects of medication. However, there were no statistically significant differences in responses between the patients receiving conventional versus second-generation antipsychotics. A positive relationship with the therapist and a positive attitude of significant others toward neuroleptic treatment contributed to patients' medication compliance. Reasons for noncompliance with neuroleptic treatment were lack of acceptance of the necessity of pharmacological treatment and lack of insight into the disease. The results emphasize the importance of psychoeducation in enhancing patient compliance with neuroleptic treatment.

摘要

尽管已经对影响精神分裂症患者接受抗精神病药物治疗依从性的几个因素进行了研究,但患者愿意或不愿意服药的主观原因却很少得到审视。在对莱比锡市目前正在接受精神治疗的一组精神分裂症患者进行的一项随访研究中,通过使用药物影响评定量表(ROMI),对307名患者询问了他们服药依从或不依从的主观原因。药物带来的感知益处被证明是患者接受抗精神病药物治疗依从性的主要原因。相应地,患者报告的不依从主要是由药物的负面副作用所解释。然而,接受传统抗精神病药物与第二代抗精神病药物治疗的患者之间的回答在统计学上没有显著差异。与治疗师的积极关系以及重要他人对抗精神病药物治疗的积极态度有助于患者的服药依从性。不接受抗精神病药物治疗的原因是缺乏对药物治疗必要性的认可以及对疾病缺乏洞察力。这些结果强调了心理教育在提高患者接受抗精神病药物治疗依从性方面的重要性。

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