Mutsatsa S H, Joyce E M, Hutton S B, Webb E, Gibbins H, Paul S, Barnes T R E
Department of Psychological Medicine, Imperial College Faculty of Medicine, St Dunstans Road, London W68 8RP, U.K.
Acta Psychiatr Scand. 2003 Dec;108(6):439-46. doi: 10.1046/j.0001-690x.2003.00193.x.
Little is known about factors that mediate adherence with medication during the early stages of antipsychotic treatment in schizophrenia. This study sought to identify factors that may be associated with medication adherence in first-episode schizophrenia.
In 101 patients, adherence was assessed along with potentially relevant variables, including attitudes toward medication, insight, substance misuse, side effects and psychopathology.
In a linear regression analysis, negative attitudes toward medication and a relative lack of insight contributed significantly towards poor adherence. Although poorly adherent patients had significantly higher scores on negative and disorganization syndromes, these did not contribute significantly towards adherence. Adverse medication side effects, subjective well-being and substance misuse showed no significant association with adherence.
At the initiation of drug treatment, attitudes toward medication and insight appear more relevant to medication adherence than side effects. Adherence appears to reflect a complex interaction of influences, which may change over time.
关于精神分裂症患者在抗精神病药物治疗早期阶段影响服药依从性的因素，我们了解得很少。本研究旨在确定首发精神分裂症患者中可能与服药依从性相关的因素。
对101名患者进行评估，同时考量一系列可能相关的变量，包括对药物的态度、自知力、物质滥用、副作用及精神病理学表现。
在线性回归分析中，对药物的消极态度以及相对缺乏自知力是导致依从性差的重要因素。尽管依从性差的患者在阴性和紊乱症状方面得分显著更高，但这些因素对依从性并无显著影响。药物副作用、主观幸福感和物质滥用与依从性无显著关联。
在药物治疗开始时，对药物的态度和自知力似乎比副作用更关乎服药依从性。依从性似乎反映了多种影响因素的复杂相互作用，且这种相互作用可能随时间而变化。
