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Predictors of noncompliance in males with first-episode schizophrenia, schizophreniform and schizoaffective disorder

  • Virginija Novak-Grubic (a1) and Rok Tavcar (a1)



Many factors influencing compliance in schizophrenia have been reported in the literature. Our aim was to assess predictors of noncompliance in male patients with first-episode schizophrenia, schizophreniform and schizoaffective disorder in a naturalistic setting.

Subjects and methods

Fifty-six male patients, discharged from hospital, were included in a 1-year follow-up study. Psychopathological symptoms were assessed with positive and negative syndrome scale at admission and discharge, while extrapyramidal side effects were recorded weekly during hospitalisation using the Simpson–Angus and Barnes akathisia scales. Socio-demographic and some other variables were also recorded.


Thirty patients (53.6%) dropped out of treatment in the first year and 21 of them relapsed. With the Cox survival analysis three predictors of noncompliance were found: diagnosis of schizophrenia versus the other two diagnoses, positive symptoms at admission, and lack of insight at discharge.


In spite of a specific methodology and selection of only first-episode male patients, the results are in accordance with the findings of other authors. This confirms the universality of noncompliance in psychotic patients.


First-episode patients have a high dropout rate. However, in compliant patients, the relapse rate was low, and therefore special attention and compliance-promoting interventions in first-episode patients are needed.


Corresponding author

*Corresponding author. Tel.: +386-1-5872-149; fax: +386-1-5284-618. E-mail address: (V. Novak-Grubic).


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1Albus, MBurkes, SScherer, JWhich factors modify drug-compliance? Psychiatr. Prax. 1995;22:228–30.
2Amador, XFFlaum, MAndreasen, NCStrauss, DHYale, SAClark, SCet al. Awareness of illness in schizophrenia and schizoaffective and mood disorder. Arch. Gen. Psychiatry 1994; 51:826–36.
3Ayers, TLiberman, RPWallace, CJSubjective response to antipsychotic drugs: Failure to replicate predictions of outcome. J. Clin. Psychopharmacol. 1984;4:89–93.
4Barnes, TREA rating scale for drug induced akathisia. Br J Psychiatry 1989;154:672–6.
5Bartko, GHerczeg, IZador, GClinical symptomatology and drug compliance in schizophrenic patients. Acta Psychiatr. Scand. 1988;77:74–6.
6Buchanan, ACompliance with Treatment in Schizophrenia, Maudsley Monograph. London: Psychology Press; 1996.
7Fenton, WSBlyler, CRHeinssen, RKDeterminants of medication compliance in schizophrenia: empirical and clinical findings. Schizophr. Bull. 1997;23:637–51.
8Fleischhacker, WWMeise, UGûnther, VKurz, MCompliance with antipsychotic drug treatment: influence of side effects. Acta Psychiatr. Scand. 1994;89(Suppl. 382):11–5.
9Gaebel, WPietzcker, AOne year outcome of schizophrenic patients - the interaction of chronicity and neuroleptic treatment. Pharmacopsychiatry 1985;18:235–9.
10Garavan, JBrowne, SGervin, MLane, ALarkin, CO’Callaghan, ECompliance with neuroleptic medication in outpatients with schizophrenia; realationship to subjective response to neuroleptics; attitudes to medication and insight. Compr. Psychiatry 1998;39:215–9.
11Hoffmann, HAge and other factors relevant to the rehospital-ization of schizophrenic outpatients. Acta Psychiatr. Scand. 1994;89:205–10.
12Kay, SRFiszbein, AOpler, LAPositive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr. Bull. 1987;13: 261–76.
13Kissling, WCompliance, quality assurance and standards for relapse prevention in schizophrenia. Acta. Psychiatr. Scand. 1994;89(Suppl. 382):16–24.
14Kissling, WKane, JMBarnes, TREDencker, SJ Fleis-chhacker WW, Goldstein, MJet al. Guidelines for neuroleptic relapse prevention in schizophrenia: towards a consensus view. In: Kissling, W editor. Guidelines for Neuroleptic Relapse Prevention in Schizophrenia. Berlin: Springer Verlag; 1994. p. 155–63.
15Kleinbaum, DGSurvival Analysis. New York: Springer-Verlag; 1997.
16Lin, IFSpiga, RFortsch, WInsight and adherence to medication in chronic schizophrenics. J. Clin. Psychiatry 1979;40: 430–2.
17Mayer, CSoyka, MCompliance bei der Therapie Schizophr-ener Patienten mit Neuroleptika - eine Übersicht. Fortschr. Neurol. Psychiatr 1992;60:217–22.
18Meltzer, HYOutcome in schizophrenia: beyond symptom reduction. J. Clin. Psychiatry 1999;60(suppl. 3):3–7.
19Parker, GHadzi-Pavlovic, DThe capacity of a measure of disability (the LSP) to predict hospital readmission in those with schizophrenia. Psychol. Med. 1995;25:157–63.
20Piatkowska, OFarnill, DMedication - compliance or alliance? A client centred approach to increasing adherence. In: Cavanagh, DJ editor. Shizophrenia - An Overview and Practical Handbook. London: Chapman & Hall; 1992. p. 339–55.
21Pristach, CASmith, CMMedication compliance and substance abuse among schizophrenic patients. Hosp Community Psychiatry 1990;41:1345–8.
22Remington, GKapur, SZipursky, RBPharmacotherapy of first-episode schizophrenia. Br. J. Psychiatry 1998;172(suppl. 33):66–70.
23Robinson, DGWoerner, MGAlvir, JMJGeisler, SKoreen, ASheitman, Bet al. Predictors of relapse following response from a first episode of schizophrenia or schizoaffective disorder. Arch. Gen. Psychiatry 1999;56:241–7.
24Sellwood, WTarrier, NDemographic factors associated with extreme noncompliance in schizophrenia. Soc. Psychiatry Psychiatr. Epidemiol. 1994;29:172–7.
25Seltzer, ARoncari, IGarfinkel, PEffect of patient education on medication compliance. Can. J. Psychiatry 1980;25:638–45.
26Shriqui, CLNeuroleptic dosing and neuroleptic plasma levels in schizophrenia: determining the optimal regimen. Can. J. Psychiatry 1995;40(Suppl. 2):38–48.
27Simpson, GMAngus, JWA rating scale for extrapyramidal side effects. Acta Psychiatr. Scand. 1970;45(Suppl. 212):11–9.
28Stip, EMemory impairment in schizophrenia: perspectives from psychopathology and pharmacotherapy. Can. J. Psychiatry 1996;41(Suppl. 2):27–34.
29Tavcar, RDernovsek, MZRecidivism in Slovenia. Psychiatr. Serv. 1997;48:955–6.
30Tehrani, EKrussel, JBorg, LMunk-Jørgensen, PDropping out of psychiatric treatment: a prospective study of a first-admission cohort. Acta Psychiatr. Scand. 1996;94:266–71.
31Van Putten, TCrumpton, EYale, CDrug refusal in schizophrenia and the wish to be crazy. Arch. Gen. Psychiatry 1976;33: 1443–6.
32Vázquez-Barquero, JLCuesta, MJ Herrera Castanedo S, Lastra, IHerran, ADunn, GCantabria first-episode schizophrenia study: three-year follow-up. Br. J. Psychiatry 1999;174:141–9.
33World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders. Diagnostic Criteria for Research. Geneva: World Health Organisation; 1993.
34Zvan, VNacela vzdrzevalne nevrolepticne terapije psihoz. Zdravstveno Varstvo 1989;28:335–41.


Predictors of noncompliance in males with first-episode schizophrenia, schizophreniform and schizoaffective disorder

  • Virginija Novak-Grubic (a1) and Rok Tavcar (a1)


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Predictors of noncompliance in males with first-episode schizophrenia, schizophreniform and schizoaffective disorder

  • Virginija Novak-Grubic (a1) and Rok Tavcar (a1)
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