조현병 환자의 클로자핀 복용지속에 영향을 미치는 요인: 질적 연구

Abstract

Objectives This study examined the psychosocial factors that influence the continuation of clozapine use among individuals with schizophrenia. This examination was conducted through in-depth qualitative interviews. Methods Thirty-one adults diagnosed with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) who had been taking Clozapine® for at least 3 months were interviewed. Data were collected from May to October 2024 and analyzed using Braun and Clarke’s thematic analysis. Results Two overarching themes emerged: 1) transformation of perceptions and engagement with treatment, including initial resistance stemming from severe symptoms and lack of insight, experiences of coercive interventions, rebuilding trust in the mental health system, and evolving attitudes toward psychiatric medications; and 2) personal recovery and social support, encompassing coping with side effects, recognizing symptom improvement and renewed hope, and the pivotal roles of family and therapeutic alliance. Trust in healthcare providers and emotional support from family were central to sustained adherence to clozapine. Conclusion Sustained clozapine use in schizophrenia patients is influenced by intertwined psychological, relational, and contextual factors. Acceptance of treatment was supported by symptom improvement, family support, and trust in healthcare providers. These elements contributed to medication adherence and broader functional recovery. A person-centered, integrated approach is essential to promote continued use and long-term outcomes.