Llorca Pierre-Michel
Centre Médico-Psychologique B, Centre Hospitalier Universitaire, Clermont-Ferrand, France.
Psychiatry Res. 2008 Nov 30;161(2):235-47. doi: 10.1016/j.psychres.2007.07.012. Epub 2008 Oct 11.
This review evaluates the impact of partial compliance on treatment outcomes in schizophrenia and discusses strategies that may be implemented to enhance compliance. As such, a search of English language articles evaluating compliance in schizophrenia was performed using Medline and EMBASE, with no time limits. Abstracts and posters presented at key psychiatry congresses were also reviewed. Results demonstrated that partial compliance with antipsychotic medication is a significant barrier to achieving optimal outcomes in schizophrenia. The problem increases with the duration of treatment, and is difficult to monitor. The impact of partial compliance is significant, leading to increases in psychotic symptoms, the risk of relapse and rehospitalization, and even suicide. Compliance is a complex phenomenon, influenced by aspects of the illness itself such as cognitive impairment and patients' health beliefs. The patient's environment and therapeutic alliance also influence medication compliance. Behavioural and pharmacological measures should be used together to improve compliance. While atypical antipsychotics have demonstrated improvements in psychotic symptoms, insight and cognition, these may not be enough to ensure compliance with oral daily medication. Long-acting risperidone may therefore bring together the benefits of the atypical antipsychotics with the long-acting injection delivery system required to build a platform for improved outcomes.
本综述评估了部分依从性对精神分裂症治疗结果的影响，并讨论了可能实施的提高依从性的策略。因此，我们使用Medline和EMBASE对评估精神分裂症依从性的英文文章进行了检索，没有时间限制。还对在主要精神病学大会上发表的摘要和海报进行了审查。结果表明，抗精神病药物的部分依从性是精神分裂症实现最佳治疗结果的重大障碍。这个问题随着治疗时间的延长而增加，并且难以监测。部分依从性的影响很大，会导致精神病症状增加、复发和再次住院的风险，甚至自杀。依从性是一个复杂的现象，受疾病本身的一些方面影响，如认知障碍和患者的健康信念。患者的环境和治疗联盟也会影响药物依从性。行为和药理学措施应结合使用以提高依从性。虽然非典型抗精神病药物已显示出在精神病症状、洞察力和认知方面有所改善，但这些可能不足以确保患者口服每日药物的依从性。因此，长效利培酮可能将非典型抗精神病药物的益处与长效注射给药系统结合起来，为改善治疗结果搭建一个平台。
