Clinical and statistical analysis of factors affecting compliance in schizophrenia patients

Abstract

Patients with schizophrenia have an increased risk of non-compliance with medical therapy, which, as a rule, leads to exacerbation or relapse of the disease, repeated hospitalization, and impaired social adaptation. The aim of the study was to analyze clinical and organizational factors that affect the compliance of schizophrenia patients. We examined 157 patients with a diagnosis of schizophrenia aged 23 to 52 (38.5±8.1) years. The study was carried out a week before discharge from the hospital. Clinical-psychopathological, clinical-dynamic, psychometric, and statistical research methods were used. It was found that only 11.4% of males and 20.7% of females were fully compliant. Taking medications under the relatives’ control was observed in a third of men and half of women. The probability (chance) of compliance overestimation by the attending physician using the clinical method is 1.8 times higher than when using the corresponding questionnaires. The higher the criticism of the disease was, the higher was patients’ compliance after discharge. The following risk factors for non-compliance in patients with schizophrenia have been identified: male gender; history of alcohol abuse; early discharge of patients from the hospital with clinically expressed anxiety, depression, and a sense of hopelessness; complete absence or insufficient explanation to the patient of the principle and procedure for taking supporting therapy; prescribing many oral or expensive drugs. Thus, compliance in schizophrenia patients is a dynamic formation, which is formed under the influence of a whole complex of individual, personal, social, environmental, and clinical factors, which should be taken into account when forming therapeutic tactics.