Compliance and psychological reactance in schizophrenia

Moore, Antonia, Sellwood, William and Stirling, John D. (2000) Compliance and psychological reactance in schizophrenia. British journal of clinical psychology, 39 (3). pp. 287-295. ISSN 0144-6657

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Abstract

Objectives. Non-compliance with neuroleptic medication in schizophrenia is a major cause of relapse. A number of sociodemographic variables, and illness, attitudinal and treatment variables, have been demonstrated to be associated with non-compliance. The present study examined a range of these variables and their predictive value in determining past and current compliance. Methods. Thirty-nine patients suåering from schizophrenia and three patients suåering from schizoaåective disorder completed a series of questionnaires assessing psychological reactance, insight, subjective response to medication, perceived threat to freedom of choice, and degree of current and past compliance. Logistic regression analyses were performed to determine which factors best predicted past and current compliance. Results. Psychological reactance and age were found to be the best predictors of past compliance, with an interaction between reactance and perceived threat to freedom of choice posed by treatment provision also making a signi®cant contribution. Past compliance behaviour and subjective response to medication predicted current compliance most signi®cantly. Conclusions. Reactance is an important predictor of compliance history especially when patients perceive treatment to be a threat to freedom of choice. Subjective response to neuroleptics is most important in predicting current compliance. Implications for intervention are discussed.