Factors affecting drug compliance among patients in Japan with schizophrenia

Factors affecting Japanese patients with schizophrenia in terms of their drug compliance were investigated. Subjects were patients with schizophrenia who were discharged from a psychiatric hospital for he first time. The target period was 24 months after discharge. Positive and Negative Symptoms Scale (PANSS), Clinical Global Impression (CGI), Global Assessment of Functioning (GAF), Drug Attitude Inventory (DAI), and The Schedule for Assessment of Insight (SAI) were adopted as rating scales. To define drug noncompliance, patients satisfying either of two criteria were chosen: an indication of "not taking medications appropriately" entered in the medical record, or inconsistency in the periods of prescription and visiting the outpatient clinic. There were 58 subjects (48.3% male), of whom 51.7% were fully compliant for 24 months after discharge. Significant factors among the good compliance group were found to be "lack of spontaneity and flow of conversation," "depression," and "emotional withdrawal" at discharge on PANSS subscales; a diagnosis of hebephrenic and residual schizophrenia, longer hospitalization and longer time from first treatment to admission, and positive attitde toward antipsychotics on the DAI scale; and "insight for treatment and drug compliance" on the SAI scale. Factors for noncompliance, on the other hand, were "uncooperativeness" and "lack of judgment and insight" in PANSS subscales at discharge, as well as gastrointestinal symptoms and drowsiness as side-effects, and less complete education.