[Subjective aspects of psychopharmacology in schizophrenia]

The authors discuss the subjective and psychodynamic aspects of pharmacotherapy in schizophrenia which are important for compliance. A large number of different factors connected with psychopharmacotherapy are of particular importance when we consider their impact on compliance. Those factors are psychopathology of patient's disease, insight, and his her intrapsychic structure as well as the great number of factors which are based on social and cultural environment of the patient. One of the most important factors is associated with the patient's family and the question how the family estimate the changes in the patient's health under the influence of medication. Other important factors include those which are rooted in the therapeutic environment of mental health service institutions and particularly in the therapeutic relationship between the patient and the treating psychiatrist. Those factors, including transference and counter-transference, may cause specific impact or even distortions ona farmacotherapeutic action of the antipsychotic drugs. The attempts to classify this compound area as well as some remarks concerning meaning of psychodynamic aspects of farmacotherapy for different groups of mental health professionals are presented in the article. The psychodynamic and subjective factors of psychopharmacotherapy are seen here as a part of a more complex field of compliance but also as those which determine a successful therapeutic outcome in the care of schizophrenic patients.