[Psychological factors, compliance and resistance to antidepressant treatment]

The compliance, or the degree of adhesion of the patient to the doctor's prescription, is a variable which must be taken into account in the interpretation of the results of a given treatment. It is generally estimated that the level of non-compliance with psychotropic or other classes of drugs is between 20 and 50% of cases. Among the factors favouring non-compliance, the authors initially discuss those related to the drug and to the modalities of prescription: severity of side effects, quality of clinical improvement obtained, complexity and duration of treatment. However, many other factors also appear to be involved, particularly related to the patient: personal beliefs and the attitude towards the disease and the drug can constitute important factors of resistance, and to the psychiatrist, whose attitude can never be considered to be neutral in relation to a particular drug or to a particular patient. The capacity of the therapist to manage and control the treatment is an essential part of the therapeutic relationship between the doctor and his patient.