Can Fam Physician. 1980 May;26:725-7.
Non-compliance is one of the commonest causes of therapeutic failure in both medicine and psychiatry. With psychiatric patients the factors contributing to non-compliance are related to: illness variables (schizophrenia, mania, paranoia, chronicity), patient variables (inappropriate health beliefs, need to rebel against authority, a wish to remain sick, defective memory), medication variables (inefficient and ineffective regimens, side effects) and patient-therapist variables (degree of supervision, trust and information).Treatment must consist of constant vigilance, health teaching-both verbal and written-enlisting the help of family and community to provide supervision, simplification of drug regimens, frequent examination and vigorous treatment of side effects, and improving the patient-therapist interaction.
不遵医嘱是医学和精神病学领域治疗失败的最常见原因之一。在精神科患者中，导致不遵医嘱的因素与以下几个方面有关：疾病变量（精神分裂症、躁狂症、偏执症、慢性疾病）、患者变量（不恰当的健康观念、反抗权威的需要、希望保持病态、记忆缺陷）、药物变量（无效和低效的治疗方案、副作用）以及患者-治疗师变量（监督程度、信任和信息）。治疗必须包括持续的警惕性、口头和书面的健康教育——争取家庭和社区的帮助提供监督、简化药物治疗方案、频繁检查和积极治疗副作用，并改善医患互动。
