Citation

Staring ABP, Mulder CL, van der Gaag M, Selten JP, Loonen AJM, Hengeveld MW. Curr. Psychiatry Rev. 2006; 2(4): 487-494.

Copyright

(Copyright © 2006, Bentham Science Publishers)

DOI

10.2174/157340006778699738

PMID

unavailable

Abstract

Non-adherence to treatment of patients with psychotic disorders is related to higher rates of relapse, hospitalization, and suicide. Important predictors of non-adherence include poor social structure, cognitive deficits, negative medication attitude, side effects, depression, a sealing-over recovery style, feelings of stigmatization, denial of treatment need, and lack of insight. Attempts to improve adherence have shown that psychoeducation alone is not fully effective, and that motivational interviewing, behavioral strategies, and linking a patient's personal goals to treatment may increase adherence. Based on the empirical data reviewed, we formed four clusters of possible causes of non-adherence, each of which can be targeted by a specific module of our developed Treatment Adherence Therapy (TAT). These four modules are: self-enhancement, motivational interviewing, medication dosage trials, and behavioral training. An individual patient may benefit from one or more of these modules; and thus the contents of TAT vary in accordance with individual causes of non-adherence. Basically, TAT aims to help patients work out what they want regarding treatment and then support them in following this through. TAT will be investigated in a multicenter randomized clinical trial in the Netherlands, starting March 2006. © 2006 Bentham Science Publishers Ltd.

Language: en

Keywords

human; suicide; female; male; Review; Therapy; Schizophrenia; depression; lifestyle; Psychosis; schizophrenia; psychosis; behavior change; scoring system; Netherlands; hospitalization; clinical trial; disease severity; patient education; review; substance abuse; outpatient; neuroleptic agent; sexual dysfunction; clinical feature; cognitive defect; sedation; life satisfaction; self report; unclassified drug; priority journal; self concept; haloperidol; doctor patient relation; hospital patient; problem solving; follow up; prediction and forecasting; patient compliance; demography; extrapyramidal symptom; meta analysis; self esteem; relapse; side effect; patient counseling; agitation; denial; Parkinson disease; Adherence; Compliance; self care; unspecified side effect; online system; stereotypy; help seeking behavior; ethical decision making; goal attainment; olanzopine; patient guidance; risperdone; social structure; vegetative stage