The problem of non-compliance in schizophrenia: Opinions of patients and their relatives. A pilot study

The relapse rate in patients suffering from schizophrenia is considerably higher than that which would be expected from the appropriate use of antipsychotics as prophylactic treatment. One of the reasons for this discrepancy is patients' non-compliance. In this study we examine reasons given by patients and their relatives as causes for past or possible future non-compliance.

Questionnaires were completed by 29 stabilized outpatients and their relatives, followed-up regularly (at least once per month), by the Mental Health Centre of Volos.

Fifty percent of the questionnaires collected from schizophrenic patients (n=22) mentioned non-compliance in the past or the possibility in the future. Among the reasons stated by patients and their relatives in general, 60% had to do with lack of knowledge about the disease, and, specifically, its course and management; 20% had to do with lack of insight, 10% with social pressure and 10% with drug side-effects. Overall 50% of the causes were related to the use of medications. The major reason for compliance (54%) was the feeling of trust in the doctor.

Mental health professionals should be aware of the high potential for non-compliance, even among regular attenders of outpatient psychiatric clinics. Part of the solution to this problem could be the provision of information to patients and relatives in lay terms, aided by written suggestions to the doctors on how to present the information. (Int J Psych Clin Pract 2000; 4:147-150).