Abstract
Factors Associated with Dropout and Noncompliance in Patients with Schizophrenia: Results of a One-Year Follow-Up
Author(s): Alp �?çok, Kazim Yazici, Levent Mete, Savas Kültür, A. Kemal Gögüs, Sahap Erkoç, Köksal AlptekinThe aim of this study was to investigate the dropout predictors for patients with schizophrenia in a naturalistic follow-up study design. After a baseline evaluation with the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI), and the UKU Side Effects Rating Scale (UKU), 382 patients with schizophrenia were scheduled for follow-up in monthly visits for one year. However, the majority of the patients (64%) dropped out prior to completion of the one-year follow-up. Patients who were less educated, had no national healthcare social security system coverage, and suffered from later onset of the illness dropped out with greater frequency. There were no differences in baseline BPRS total and subscale scores between patients who completed the one-year follow-up or dropped out; dropout patients had higher BPRS suspiciousness scores. Compliance to medication was also higher in patients who completed the one-year followup. We found no differences in compliance among the patients who took atypical antipsychotics, typical antipsychotics, or a combination of the two. Age of onset and BPRS suspiciousness scores were inversely correlated with the duration of follow-up. The patients who took haloperidol dropped out earlier than those who took risperidone, clozapine, or olanzapine. There were no differences between patients taking depot antipsychotic medications versus those taking oral antipsychotics in terms of treatment compliance, duration of follow-up, and dropout rates. Our findings suggest that dropout and compliance remain severe problems in the treatment of patients with schizophrenia, and that these problems are multifaceted, involving patient-related, treatment setting-related, and treatment-related factors.