Compliance in psychoses

Objective: To review the literature on compliance in psychoses and to evalu ate the significance of the different compliance components presented. Method: Different definitions of the term compliance were first gathered. A search covering the years 1974-1997 was conducted in Medline and PsycLit d atabases using the keywords 'schizophrenia' or 'psychosis' and 'compliance' . The studies that took compliance into account as a separate variable were collected for further analysis. Results: Unpleasant side-effects of medication, attitudes towards medicatio n, delusional symptoms, substance abuse, insight, and supportive family env ironment were found to have the strongest correlation with compliance. The influence of cognitive impairment is not clearly proven. Integrated, cognit ive-behavioural and psychoeducational treatment models include several meth ods to improve therapeutic alliance and compliance. Conclusion: As the majority of the studies have concentrated on neuroleptic treatment? the medication-related factors are best documented. In clinical practice, treatment compliance is based on patient-related, medication-rel ated and interactional factors, such as treatment model and therapeutic all iance. Difficulties with insight and cognitive functioning are specific pat ient-related factors in the treatment of psychoses.