COMPLIANCE DURING TREATMENT WITH ANTIDEPRESSANTS

Compliance has become a topic of intense investigation and debate duri ng the past two decades. The present review first examines to what fac tors the exponential increase in research studies on the topic can be attributed. A second part summarizes the history of the concept, the d efinitions and measurements of compliance and the estimations of compl iance and non-compliance. Studies searching for relevant components of compliance behavior can be divided in two groups. A first group of pu blications originates from a biomedical and pharmaceutical approach, a nd investigates which characteristics of illness, of drug regimen or d rug side effects, of patients, doctors or their practices can predict the variance in compliance. The implicit aim of these studies is the d evelopment of strategies leading to increased compliance. A second gro up of publications originates from medical psychology (psychodynamic, cognitive-behavior and interactional considerations) and investigates why a given patient is compliant or not, sometimes even suggesting tha t non-compliance can even be a meaningful response. The present review suggests that the relation between the occurrence of side effects and noncompliance during treatment with antidepressant drugs is more comp lex than usually accepted and that, incase of non-compliance, finding an equilibrium between authoritarian tactics and passive avoidance doe s remain one of the challenges in daily practice. (C) 1997 Elsevier Sc ience B.V.