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首页> 外文期刊>The journal of clinical psychiatry >Understanding and addressing adherence issues in schizophrenia: from theory to practice.
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Understanding and addressing adherence issues in schizophrenia: from theory to practice.

机译：理解和解决精神分裂症的依从性问题：从理论到实践。

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If an easy answer to the problem of medication nonadherence in schizophrenia existed, it would have already been found. Despite the magnitude of the problem, in the past decade, significant advances have been made in understanding the nature of the adherence problem in schizophrenia. Just as there is no single adherence intervention but a range of interventions that can be matched to the specific challenges of the individual patient, there is not a single theory that explains adherence and non-adherence. Rather, there are a range of theories and concepts, with their own strengths and limitations. The goal of this article is to help provide a crosswalk from some of the emerging theories and concepts to practical clinical management approaches. To enhance understanding of this complex issue and help practitioners implement practical therapeutic interventions that encourage adherence, the following 5 theories regarding medication adherence are presented and suggestions made for applying them in clinical practice: (1) Adherence is not a clinical outcome and only matters as it interferes with outcome. (2) In schizophrenia, adherence problems are often entangled with efficacy limitations of antipsychotics. (3) Adherence can be viewed as a behavior (takingot taking) or an attitude (prefers taking/prefers stopping). (4) When considering adherence attitudes, patient belief is always reality. (5) Adherence behavior changes and fluctuates over time and should be considered as part of the illness in the context of the long-term trajectory of desired clinical outcomes such as recovery.
机译：如果对精神分裂症的药物不依从问题存在一个简单的答案，那就已经找到了。尽管存在严重的问题，但在过去十年中，在了解精神分裂症的依从性问题的性质方面已取得了重大进展。就像没有单一的依从性干预措施，而是一系列可以与个别患者的具体挑战相匹配的干预措施一样，也没有单一的理论可以解释依从性和不依从性。相反，有一系列的理论和概念，各有千秋。本文的目的是帮助从新兴理论和概念到实践临床管理方法的交流。为了增进对这一复杂问题的理解并帮助从业人员实施鼓励依从性的实用治疗干预措施，提出了以下有关药物依从性的5种理论，并提出了将其应用于临床的建议：（1）依从性不是临床结果，仅与它会干扰结果。 （2）在精神分裂症中，依从性问题常常与抗精神病药的功效局限纠缠在一起。 （3）坚持可以被视为一种行为（采取/不采取）或一种态度（倾向于采取/倾向于停止）。 （4）在考虑坚持态度时，患者的信念始终是现实。 （5）依从行为随时间变化和波动，在预期的临床结果（如康复）的长期轨迹中，应将其视为疾病的一部分。

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