Summary:
Before the psychopharmacological era, the main aims of treatment were the improvement of selfcare,
reduction of aggression and self-injury. After the arrival of antipsychotics (AP) the aims of treatment
have been becoming more ambitious. Nowadays, remission, improvement of functioning and
quality of life are the goals. Remission is defined in terms of symptoms, similarly to affective disorders.
Remission is significantly connected with compliance (adherence to the treatment). Studies
dealing with these problems suggest that about two thirds of patients do not take AP as prescribed,
or even do not take them at all. The ADHES study was aimed at psychiatrists’ understanding of factors
leading to insufficient adherence. Questionnaire-based naturalistic survey that incorporated 80
psychiatrists and 820 of their patients has found that Czech psychiatrists’ opinions do not differ
from those of psychiatrists from other countries. The incidence of partial compliance and noncompliance
has been evaluated in accordance with the available literature. Psychiatrists judged that the
impairment of cognitive functioning, life conditions and stigma were important factors in about half
of their patients, in smaller proportion of patients it was co-morbid substance abuse. With the availability
of atypical AP (with better tolerability), long-acting atypicals (positive influence of compliance)
and continuous psychoeducation, remission becomes an attainable clinical goal.
Key words:
schizophrenia, remission, compliance.
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