A Trial of Compliance Therapy in Outpatients With Schizophrenia or Schizoaffective Disorder
J Clin Psychiatry 2005;66(8):997-1001
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: To evaluate the efficacy of
compliance therapy when delivered to outpatients with
schizophrenia or schizoaffective disorder.
Method: Thirty patients with schizophrenia or
schizoaffective disorder (DSM-IV criteria) were recruited from
urban psychiatric outpatient clinics in an open trial of
compliance therapy. Compliance therapy is a
cognitive/psychoeducational approach consisting of 4 to 6
sessions lasting 30 to 60 minutes each. The primary outcome was
electronically measured antipsychotic medication adherence.
Adherence data were analyzed for effects during an initial
treatment period (month -1 to month +1) and a subsequent 5-month
follow-up period. Secondary outcome measures included clinician
and patient ratings of adherence, symptoms, insight, and
attitudes to medication treatment. Data were collected from
August 2001 to January 2004.
Results: Compliance therapy was not associated
with improvements in antipsychotic medication adherence. Patient
ratings of adherence improved during the month -1 to month +1
period, but not in the subsequent 5-month follow-up. A diagnosis
of schizoaffective disorder was associated with poorer adherence
than was a diagnosis of schizophrenia during the month -1 to
month +1 period. A higher degree of insight at baseline (end of
month -1) was associated with greater adherence in the 5-month
follow-up period. Symptoms, insight, and attitudes to medication
treatment did not change significantly during the study.
Conclusion: In this uncontrolled trial,
outpatients with schizophrenia or schizoaffective disorder did
not benefit from compliance therapy.