Compliance in schizophrenic patients: A cross-sectional study

Aim was to evaluate patients‘ compliance as judged by their treating psychiatrists. Psychiatrists (hospital, office-based) were asked to judge the compliance of 10 schizophrenic patients during a 10-day period in June 2004 by a questionnaire with 10 questions: ‘compliance during the previous month’, ‘lifetime-compliance’, ,insight into illness/denial’, ‘relapse prevention’, ,cognitive deficits’, ‘use of alcohol/drugs’, ‘social/living conditions’, ‘stigmatisation’. Demographic data of the psychiatrists were elicited. Descriptive statistics were used. 703 psychiatrists participated. 47% treated inpatients, 16% worked in outpatient units, 40% were office-based. The compliance of 5670 schizophrenic patients was judged. According to psychiatrists, 69% of patients did not take medication as prescribed on at least one day during the previous month; 69% discontinued medication on their own. 65% showed lack of insight into illness/denial of illness. Relapse prevention was discontinued by 67%. Cognitive deficits were observed in 59% of patients. A current or recent use of alcohol/drugs was assumed in 35%. Psychiatrists were concerned about difficult social conditions or stigmatisation in 54% of patients. Two of three schizophrenic patients are not compliant in the opinion of their treating psychiatrist. Reasons appear widespread and may include lack of insight into illness, cognitive deficits or stigmatisation. Therefore, compliance needs to be improved by appropriate measures.