Lencer R, Korn D
Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Geb. A9, 48149, Münster, Deutschland,
Nervenarzt. 2015 May;86(5):637-46; quiz 647-8. doi: 10.1007/s00115-015-4275-z.
Effective psychopharmacological medication with good tolerability represents the cornerstone of treatment for severe mental illness; however, the 1-year adherence rates are only approximately 50%. The term adherence emphasizes the collaborative responsibility of the clinician and the patient for a positive treatment outcome. Reasons for non-adherence are manifold and include patient-specific factors, such as self-stigmatization, lack of social and familial support, cognitive impairment and substance use besides insufficient effectiveness and the occurrence of side effects of the psychotropic drugs. To enhance adherence, both clinician and patient have to fully understand all the reasons for and against adherence to medication before a collaborative decision is made on future long-term treatment. A positive attitude towards medication critically depends on whether patients feel that the medication supports the attainment of the individual goals.
有效的、耐受性良好的精神药物是重症精神疾病治疗的基石；然而，1年的服药依从率仅约为50%。“依从性”一词强调临床医生和患者对积极治疗结果的共同责任。不依从的原因是多方面的，除了精神药物疗效不足和出现副作用外，还包括患者特有的因素，如自我污名化、缺乏社会和家庭支持、认知障碍以及物质使用。为了提高依从性，临床医生和患者在就未来的长期治疗做出共同决定之前，必须充分了解支持和反对服药的所有原因。对药物的积极态度关键取决于患者是否觉得药物有助于实现个人目标。
