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Randomised controlled trial of compliance therapy

18-month follow-up

Published online by Cambridge University Press:  03 January 2018

Roisin Kemp ,
George Kirov ,
Brian Everitt ,
Peter Hayward  and
Anthony David
Roisin Kemp*
Affiliation:
University Department of Psychiatry, Royal Free Hospital, London
George Kirov
Affiliation:
Department of Psychological Medicine, University of Wales College of Medicine, Cardiff
Brian Everitt
Affiliation:
Department of Biostatistics and Computing, Institute of Psychiatry, London
Peter Hayward
Affiliation:
Maudsley Hospital and Department of Psychology, Institute of Psychiatry, London
Anthony David
Affiliation:
Department of Psychological Medicine, King's College Hospital and Institute of Psychiatry, London
*
Dr Roisin Kemp, University of Psychiatry, Royal Free Hospital, Pond Street, London NW3 2QG. Tel: 0171 794 0500. Fax: 0171 830 2808. E-mail: r.kemp@rfhsm.ac.uk
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Abstract

Background

A randomised controlled trial was conducted in an acute treatment setting to examine the effectiveness of compliance therapy, a brief pragmatic intervention targeting treatment adherence in psychotic disorders, based on motivational interviewing and recent cognitive approaches to psychosis.

Method

Seventy-four patients with psychotic disorders according to DSM–III–R criteria recruited from consecutive admissions to an acute in-patient unit, received 4–6 sessions of either compliance therapy or non-specific counselling, and were followed-up over 18 months. The principal outcome measures were observer-rated compliance, attitudes to treatment, insight and social functioning.

Results

Significant advantages were found for the compliance therapy group post-treatment on measures of insight, attitudes to treatment and observer-rated compliance which were retained over the follow-up period. Global social functioning improved relatively more over time in the compliance therapy group compared with the control group. Survival in the community prior to readmission was significantly longer in the compliance therapy group.

Conclusions

The results support the effectiveness of compliance therapy in improving functioning and community tenure after an acute psychotic episode.

Information

Type
Papers
Information
The British Journal of Psychiatry , Volume 172 , Issue 5 , May 1998 , pp. 413 - 419
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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Footnotes

†

Related paper pp. 420–424, this issue.

References

Amador, X. F., Flaum, M., Andreasen, N. C., et al (1994) Awareness of illness in schizophrenia and schizoaffective and mood disorders. Archives of General Psychiatry, 51, 826–836.Google Scholar
Amador, X. F., Friedman, J. H., Kasapis, C., et al (1996) Suicidal behaviour in schizophrenia and its relationship to awareness of illness. American Journal of Psychiatry, 153, 1185–1188.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised). Washington, DC: APA.Google Scholar
Babiker, I. E. (1986) Noncompliance in schizophrenia. Psychiatric Developments, 4, 329–337.Google ScholarPubMed
Barnes, T. R. E. (1989) A rating scale for drug-induced akathisia. British Journal of Psychiatry, 154, 672–676.Google Scholar
Beecham, J. K. & Knapp, M. R. J. (1992) Costing psychiatric interventions. In Measuring Mental Health Needs (eds G. Thornicroft, C. Brewin & J. K. Wing), pp. 163–183. London: Gaskell.Google Scholar
Churchill, D. N. (1985) Compliance – how to measure it. Modern Medicine of Canada, 40, 1068–1070.Google Scholar
Corrigan, P. W., Liberman, R. P. & Engel, J. D. (1990) From noncompliance to collaboration in the treatment of schizophrenia. Hospital and Community Psychiatry, 41, 1203–1211.Google Scholar
Cox, D. R. (1972) Regression models and life tables. Journal of the Royal Statistical Society, 34, 187–200.Google Scholar
David, A. S. (1990) Insight and psychosis. British Journal of Psychiatry, 156, 798–808.Google Scholar
Diggle, P. J. & Kenward, M. G. (1994) Informative drop-outs in longitudinal data analysis. Applied Statistics, 43, 49–93.Google Scholar
Diggle, P. J., Liang, K. Y. & Zeger, S. L. (1994) Analysis of Longitudinal Data. Oxford: Oxford Science Publications.Google Scholar
Drury, V., Birchwood, M., Cochrane, R., et al (1996) Cognitive therapy and recovery from acute psychosis: a controlled trial: I. Impact on psychotic symptoms. British Journal of Psychiatry, 169, 593–601.Google Scholar
Everitt, B. S. (1995) The analysis of repeated measures: a practical review with examples. Statistician, 44, 113–135.CrossRefGoogle Scholar
Everitt, B. S. (1998) Analysis of longitudinal data. Beyond MANOVA. British Journal of Psychiatry, 172, 7–10.Google Scholar
Falloon, I. R. (1984) Developing and maintaining adherence to long-term drug-taking regimens. Schizophremo Bulletin, 10, 412–417.CrossRefGoogle ScholarPubMed
Garety, P. A., Kulpers, L., Fowler, D., et al (1994) Cognitive behavioural therapy for drug-resistant psychosis. British Journol of Medical Psychology, 67, 259–271.CrossRefGoogle ScholarPubMed
Goldstein, M. J. (1992) Psychosocial strategies for maximizing the effects of psychotropic medications for schizophrenia and mood disorder. Psychopharmacology Bulletin, 28, 237–240.Google Scholar
Hayward, P., Chan, N., Kemp, R., et al (1995) Medication self-management: a preliminary report on an intervention to improve medication compliance. Journal of Mental Health, 4, 511–517.CrossRefGoogle Scholar
Hogan, T. P., Awad, A. G. & Eastwood, R. (1983) A self report scale predictive of drug compliance in schizophrenics: Reliability and discriminative validity. Psychological Medicine, 13, 177–183.CrossRefGoogle ScholarPubMed
Kane, J. (1983) Problems of compliance in the outpatient treatment of schizophrenia. Journal of Clinical Psychiatry, 44, 3–6.Google ScholarPubMed
Kemp, R., Hayward, P., Applewhaite, G., et al (1996a) Compliance therapy in psychotic patients: randomised controlled trial. British Medical Journal, 312, 345–349.CrossRefGoogle ScholarPubMed
Kemp, R., David, A. & Hayward, P. (1996b) Compliance therapy: An intervention targeting insight and treatment adherence in psychotic patients. Behavioural and Cognitive Psychotherapy 24, 331–350.Google Scholar
Kemp, R., & David, A. (1997) Insight and Compliance. In Compliance and the Treatment Alliance in Serious Mental Illness (ed. B. Blackwell). Newark. NJ: Gordon and Breach Publishing Group.Google Scholar
Lukoff, D., Nuechterlein, K. H. & Ventura, J. (1996) Manual for the expanded BPRS. Schizophrenia Bulletin, 12, 594–602.Google Scholar
McGorry, P. D. (1995) Psychoeducation in first-episode psychosis – a therapeutic process. Psychiatry, 58, 313–328.Google Scholar
Nelson, H. E. (1982) National Adult Reading Test (NART): test manual. Windsor: NFER.Google Scholar
Pullar, T., Kumar, S., Tindall, H., et al (1989) Time to stop counting the tablets? Clinical Pharmacology and Therapeutics, 46, 163–168.Google Scholar
Royal Pharmaceutical Society of Great Britain (1997) From Compliance to Concordance: Towards Shared Goals in Medicine Taking. London: RPS.Google Scholar
Rudd, P. (1976) In search of the gold standard for compliance measurement. Archives of Internal Medicine, 139, 627–628.Google Scholar
Simpson, G. M. & Angus, J. W. S. (1970) Drug-induced extra-pyramidal disorders. Acta Psychiatrica Scandmavica, 45 (suppl. 212): 11–19.Google Scholar
Terrier, N., Beckett, R., Harwood, S., et al (1993) A trial of two cognitive-behavioural methods of treating drug-resistant residual psychotic symptoms in schizophrenic patients. I. Outcome. British Journal of Psychiatry, 162, 524–532.CrossRefGoogle Scholar

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