SYMPTOMS OR SIDE-EFFECTS - METHODOLOGICAL HAZARDS AND THERAPEUTIC PRINCIPLES

The case is described of a 40 year old man with delusions and hallucin ations, who at the start of this study was taking doses of neuroleptic medication greatly in excess of those that have been demonstrated to be optimally effective. Over 48 weeks, using PQ methods and detailed i nterviewing, his progress was charred as the medication was reduced to more appropriate levels. Across this change, his delusional beliefs r emained unchanged, but there were substantial reductions in auditory h allucinations, as well as in hopelessness and anxiety. The case has im plications for concepts of therapy in the psychoses and for the method ology of therapy studies. It also illustrates possible benefits of usi ng PQ or other self-assessment methods as a means of calibrating thera py and perhaps enhancing compliance. (C) 1998 John Wiley & Sons, Ltd.