It is now personal: recent views on the assessment of therapeutic infidelity in severe mental illness

This paper starts with an attempt to chart the contemporary history of the term "Compliance" and its cognates. It also discusses the recently published guidelines concerning the assessment of adherence in patients with serious mental illnesses, dedicating its middle part to comment on the research and clinical methods to assess adherence in patients. The current consensus amongst experts can be summarized, from a clinical point of view, in a simple rule of thumb: enhancing adherence should depend on simple interventions originating from a multidisciplinary perspective and should include patients' input. Despite its apparent simplicity, improving the assessment of adherence and favouring its enhancement can generate interesting ethical quandaries that will be approached in the light of the relatively new emergent notion of "moral distress.".