In a study of 58 patients with schizophrenia, 26 were considered to be adherent while 32 were considered to be nonadherent based on missed appointments and deliberate discontinuation of treatment.
Upon discharge, patients were assessed using the GAS, which includes 2 items rated using 4 degrees of severity:
- “Lack of feeling of illness” (the patient denies being ill either spontaneously or when interviewed).
- “Lack of insight into illness” (the patient fails to acknowledge his/her emotional state and the behavior assessed as pathologic by the physician and does not perceive the necessity of treatment).
Nonadherent patients demonstrated significantly higher scores for both “lack of feeling of illness” and “lack of insight into illness”.
“Lack of feeling of illness” and lack of “insight into illness” can be regarded as risk factors for nonadherence.
Reference:
Bartkó G, Herczeg I, Zádor G. Clinical symptomatology and drug compliance in schizophrenic patients. Acta Psychiatr Scand. 1988; 77(1): 74-76.