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The Adaptive Features of Schizophrenia Patients in Early Revealing and Correction of the non-compliance with a Therapy

E.G. Dmitrieva, A.V. Semke, N.A. Bokhan, V.V. Dubrovskaya
Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia

SUMMARY:
Objective - to define the effects of early revealing of the non-compliance risk in therapy and correction with the help of a specialized treatment and rehabilitation complex for adaptation in patients with schizophrenia.
Patients and Methods. The study included 68 patients with a verified diagnosis of schizophrenia according to ICD-10, undergoing in-patient treatment at the Mental Health Research Institute Clinic. Using the "Method of predicting violations in adherence to therapy for subsequent correction in patients with schizophrenia"; patients who were at risk of disrupting therapy were identified. These patients were included in a specialized treatment and rehabilitation complex in order to increase adherence to therapy. Further, an assessment of the dynamics of drug compliance with the help of the "Method for predicting drug compliance in psychiatry", the number of rehospitalizations due to treatment disorders and adaptation process using methods developed in the Research Institute of Mental Health.
Results. In the group of patients with schizophrenia, when the risk of treatment disorders was detected and the complex of specialized treatment and rehabilitation measures were performed, the level of drug compliance increased, the number of rehospitalizations decreased, as well as the share of rehospitalizations due to disruption of maintenance therapy, the proportion of patients who formed the most favorable types of adaptation increased and favorable individual compensatory-adaptive protection. Within six months after the completion of the stationary stage, without active support from the psychiatric service, the reverse dynamics of the improvements achieved in adaptation was observed.
Conclusions. Earlier, the identification of patients with schizophrenia with a risk of non-compliance and therapy and their inclusion in a specialized treatment and rehabilitation course increases drug compliance and improves the adaptation of patients with schizophrenia. However, without the constant active participation from the psychiatric service, the positive effect achieved is gradually lost.

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