Noncompliance in schizophrenia

Compliance research is reviewed with particular reference to neuroleptic treatment of schizophrenia. Reported noncompliance rates of up to 50 per cent are likely to be an underestimate. Models of compliance and health-seeking behaviour borrowed from physical medicine are of questionable relevance to schizophrenia where perception of illness is often distorted. Factors thought to be implicated in noncompliance need to be evaluated and a theoretical model applicable to schizophrenia constructed. In the meantime there is evidence to suggest that behavioural intervention strategies may be superior to simple educational ones in the management of noncompliance. A discussion of methodological issues relating to the assessment of compliance is offered and a strategy for further research outlined.