Long-term illness and patterns of medicine taking: are people with schizophrenia a unique group?

Patients with schizophrenia relapse because of inadequate levels of medicine taking. Therefore, it seems logical to learn about the factors underpinning their medicine-taking decisions. Further research is urgently needed to explore this area and thereby to refine models of practice, to promote therapeutic interactions with medicine. Existing research tends to share three common deficits. * It is grounded in the worldview of the psychiatrist not the patient. * It studies the influence of symptoms on compliance behaviour in isolation from other potential variables. * It overlooks the potential influence of the chronicity experience in general by examining schizophrenia outwith the context of other enduring illnesses. Overall these deficits may combine to distort the influence of schizophrenic symptoms on medicine decision making and justify a coercive rather than an empowering approach. A pernicious self-fulfilling spiral may be contributing to the problem of relapse in schizophrenia. Potentially the mental health nurse has a role in addressing this problem.