조현병 환자의 병명인지에 따른 약물치료에 대한 태도
Attitude Toward Antipsychotic Treatment According to Patients’ Awareness of the Name of Their Illness in Patients with Schizophrenia
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Objectives : This study compared attitudes toward antipsychotic treatment according to awareness of the name of their illness in patients with schizophrenia. Methods : Information on sociodemographic and clinical characteristics, including awareness of the importance of antipsychotic treatment, was obtained through a self-report questionnaire. The Drug Attitude Inventory (DAI) was administered. The data were compared according to awareness of the name of their illness. Results : The study analyzed data for 199 patients with schizophrenia. Of these, 115 patients (57.8%) were aware that their illness was called schizophrenia, while 84 patients (42.2%) knew it by their psychotic symptoms or as another mental illness, such as depression. The patients aware of the name of their illness had significantly longer durations of illness and higher scores on the DAI. They were significantly more likely to have stopped taking medication on their own accord and to agree with the importance of antipsychotic treatment. Statistical significance was sustained in a logistic regression analysis after adjusting for the duration of illness and study site, except for the DAI score, which had borderline significance (p=0.055). In subjects with duration of illness ≥5 years, patients aware of the name of their illness had significantly higher scores on the DAI. Conclusion : Awareness of the name of their illness was associated with awareness of the importance of, and a positive attitude toward, antipsychotic treatments in patients. Psycho-education, including telling the patient the correct name of his or her illness, might be needed for maintaining antipsychotic treatment in patients with chronic schizophrenia.
Abstract
Objectives : This study compared attitudes toward antipsychotic treatment according to awareness of the name of their illness in patients with schizophrenia. Methods : Information on sociodemographic and clinical characteristics, including awareness of the importance of antipsychotic treatment, was obtained through a self-report questionnaire. The Drug Attitude Inventory (DAI) was administered. The data were compared according to awareness of the name of their illness. Results : The study analyzed data for 199 patients with schizophrenia. Of these, 115 patients (57.8%) were aware that their illness was called schizophrenia, while 84 patients (42.2%) knew it by their psychotic symptoms or as another mental illness, such as depression. The patients aware of the name of their illness had significantly longer durations of illness and higher scores on the DAI. They were significantly more likely to have stopped taking medication on their own accord and to agree with the importance of antipsychotic treatment. Statistical significance was sustained in a logistic regression analysis after adjusting for the duration of illness and study site, except for the DAI score, which had borderline significance (p=0.055). In subjects with duration of illness ≥5 years, patients aware of the name of their illness had significantly higher scores on the DAI. Conclusion : Awareness of the name of their illness was associated with awareness of the importance of, and a positive attitude toward, antipsychotic treatments in patients. Psycho-education, including telling the patient the correct name of his or her illness, might be needed for maintaining antipsychotic treatment in patients with chronic schizophrenia.
참고문헌 (63)
- Kane JM, "Schizophrenia", N Engl J Med, 334, pp.34~41 (1996)
- Davis JM, "Overview: maintenance therapy in psychiatry: I. Schizophrenia", Am J Psychiatry, 132, pp.1237~1245 (1975)
- Lieberman JA, "Effectiveness of antipsychotic drugs in patients with chronic schizophrenia", N Engl J Med, 353, pp.1209~1223 (2005)
- Kissling W, "Compliance, quality assurance and standards for relapse prevention in schizophrenia", Acta Psychiatr Scand Suppl, 382, pp.16~24 (1994)
- Coldham EL, "Medication adherence of individuals with a first episode of psychosis", Acta Psychiatr Scand, 106, pp.286~290 (2002)
- Lacro JP, "Prevalence of and risk factors for medication nonadherence in patients with schizophrenia: a comprehensive review of recent literature", J Clin Psychiatry, 63, pp.892~909 (2002)
- Valenstein M, "Antipsychotic adherence over time among patients receiving treatment for schizophrenia: a retrospective review", J Clin Psychiatry, 67, pp.1542~1550 (2006)
- Zygmunt A, "Interventions to im-prove medication adherence in schizophrenia", Am J Psychiatry, 159, pp.1653~1664 (2002)
- 유지희, "일 대학병원 정신과 외래 환자의 약물 순응도에 영향을 미치는 요인", 대한정신약물학회지, 21(1), pp.29~34 (2010), 대한정신약물학회
- Kwon JS, "Medication Compliance in Psychiatric Outpatients of a University Hospital", J Korean Neuropsychiatr Assoc, 36, pp.523~529 (1997)
- Kim SW, "Survey of medication adherence in pa-tients with schizophrenia-Korean ADHES data", Hum Psychopharmacol, 21, pp.533~537 (2006)
- Ascher-Svanum H, "Medication adherence and long-term functional outcomes in the treatment of schizophrenia in usual care", J Clin Psychiatry, 67, pp.453~460 (2006)
- Novick D, "Predictors and clinical consequences of non-adherence with antipsychotic medication in the outpatient treatment of schizophrenia", Psychiatry Res, 176, pp.109~113 (2010)
- Dutta R, "Early risk factors for suicide in an epidemiological first episode psychosis cohort", Psychiatry Res, 126, pp.11~19 (2011)
- Linden M, "The differentiation between ‘lack of insight’ and ‘dysfunctional health beliefs’ in schizophrenia", Psychopathology, 40, pp.236~241 (2007)
- Amador XF, "Assessment of insight in psychosis", Am J Psychiatry, 150, pp.873~879 (1993)
- Kampman O, "Indicators of medication compliance in first-episode psy-chosis", Psychiatry Res, 110, pp.39~48 (2002)
- David AS, "Insight and psychosis", Br J Psychiatry, 156, pp.798~808 (1990)
- Yen CF, "Relationships between insight and medication adherence in outpatients with schizophrenia and bipolar disorder: prospective study", Psychiatry Clin Neurosci, 59, pp.403~409 (2005)
- Day JC, "Attitudes toward antipsychotic medication: the impact of clinical variables and relationships with health professionals", Arch Gen Psychiatry, 62, pp.717~724 (2005)
- Kim SW, "Association between attitude toward medication and neurocognitive function in schizophrenia", Clin Neuropharmacol, 29, pp.197~205 (2006)
- Kim SW, "The analysis of newspaper-ar-ticles on psychosis", J Korean Neuropsychiatr Assoc, 39, pp.838~848 (2000)
- Kim SW, "The stigmatization of psychosis in Korean Newspaper articles", Korean J Schizophr Res, 14, pp.42~49 (2011)
- Ono Y, "Schizophrenia: is it time to replace the term?", Psychiatry Clin Neurosci, 53, pp.335~341 (1999)
- Chung KF, "Can a less pejorative Chinese translation for schizophrenia reduce stigma? A study of adolescents’ attitudes toward people with schizophrenia", Psychiatry Clin Neurosci, 58, pp.507~515 (2004)
- 김성완, "‘조현병-정신분열병’ 병명에 따른 낙인 비교", 신경정신의학, 51(4), pp.210~217 (2012), 대한신경정신의학회
- American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorders. 4th ed" (1994), American Psychiatric Press Inc
- Hogan TP, "A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity", Psychol Med, 13, pp.177~183 (1983)
- 윤보현, "한국판 약물태도 척도의 심리측정적 특성", 대한정신약물학회지, 16(6), pp.480~487 (2005), 대한정신약물학회
- Amador XF, "Awareness of illness in schizophrenia and schizoaffective and mood disorders", Arch Gen Psychiatry, 51, pp.826~836 (1994)
- Thompson KN, "Reduced awareness of illness in first-episode psychosis", Compr Psychiatry, 42, pp.498~503 (2001)
- Gaebel W, "Drug attitude as predictor for effectiveness in first-episode schizophrenia: Results of an open randomized trial (EUFE-ST)", Eur Neuropsychopharmacol, 20, pp.310~316 (2010)
- Kamali M, "A prospective evaluation of adherence to medication in first episode schizophrenia", Eur Psychiatry, 21, pp.29~33 (2006)
- Wong MM, "Medication adherence and sub-jective weight perception in patients with first-episode psychotic dis-order", Clin Schizophr Relat Psychoses, 5, pp.135~141 (2011)
- Aleman A, "Insight in psychosis and neuropsychological function: meta-analysis", Br J Psychiatry, 189, pp.204~212 (2006)
- Amador XF, "Psychopathologic domains and insight in schizophrenia", Psychiatr Clin North Am, 21, pp.27~42 (1998)
- Markova IS, "The meaning of insight in clinical psychiatry", Br J Psychiatry, 160, pp.850~860 (1992)
- Cuffel BJ, "Awareness of illness in schizophrenia and outpatient treatment adherence", J Nerv Ment Dis, 184, pp.653~659 (1996)
- Donohoe G, "Predictors of compliance with neuroleptic medication among inpatients with schizophrenia: a discriminant function analysis", Eur Psychiatry, 16, pp.293~298 (2001)
- Kozuki Y, "Lack of awareness and nonadherence in schizophrenia", West J Nurs Res, 25, pp.57~74 (2003)
- Mutsatsa SH, "Clinical correlates of early medication adherence: West London first episode schizophrenia study", Acta Psychiatr Scand, 108, pp.439~446 (2003)
- Smith TE, "The relative influences of symptoms, insight, and neurocognition on social adjustment in schizophrenia and schizoaffective disorder", J Nerv Ment Dis, 187, pp.102~108 (1999)
- Watson PW, "Emotional dysfunction in schizophrenia spectrum psychosis: the role of illness perceptions", Psychol Med, 36, pp.761~770 (2006)
- Tait L, "Predicting engagement with services for psychosis: insight, symptoms and recovery style", Br J Psychiatry, 182, pp.123~128 (2003)
- Lincoln TM, "Correlates and long-term consequences of poor insight in patients with schizophrenia", Schizophr Bull, 33, pp.1324~1342 (2007)
- Park JI, "Renaming the term “schizophrenia” in Korea", Korean J Schizophr Res, 11, pp.107~117 (2008)
- Green RS, "Telling patients and families the psychiatric diagnosis: a survey of psychiatrists", Hosp Community Psychiatry, 38, pp.666~668 (1987)
- Mitchell AJ, "Reluctance to disclose difficult diagnoses: a narrative review comparing communication by psychiatrists and oncologists", Support Care Cancer, 15, pp.819~828 (2007)
- Clafferty RA, "Conspiracy of silence? Telling patients with schizophrenia their diagnosis", Psychiatr Bull R Coll Psychiatr, 25, pp.339~ (2001)
- Clafferty RA, "Telling patients with schizophrenia their diagnosis. Patients should be informed about their illness", BMJ, 321, pp.384~385 (2000)
- Atkinson JM, "To tell or not to tell the diagnosis of schizophrenia", J Med Ethics, 15, pp.21~24 (1989)
- Nishimura Y, "Studies on the effects of renaming psychiatric disorders", Ministry of Health, Labor and Welfare, pp.6~13 (2005)
- Sato M, "Prevalence of “Togo Shitcho Sho” (schizophrenia) and the ripple effect, In Studies on the effects of renaming psychiatric disorders", pp.14~18 (2005), Ministry of Health, Labor and Welfare
- Mitsumoto Sato, "Integration disorder: the process and effects of renaming schizophrenia in Japan", Korean J Schizophr Res, 11, pp.65~70 (2008)
- Staring AB, "Stigma moderates the associations of insight with depressed mood, low self-esteem, and low quality of life in patients with schizophrenia spectrum disorders", Schizophr Res, 115, pp.363~369 (2009)
- Cooke M, "Insight, distress and coping styles in schizophrenia", Schizophr Res, 94, pp.12~22 (2007)
- Lysaker PH, "Toward understanding the insight paradox: internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders", Schizophr Bull, 33, pp.192~199 (2007)
- Schwartz RC, "Suicidality and psychosis: the predictive potential of symptomatology and insight into illness", J Psychiatr Res, 38, pp.185~191 (2004)
- Amador XF, "Suicidal behaviour in schizophrenia and its relationship to awareness of illness", Am J Psychiatry, 153, pp.1185~1188 (1996)
- Schwartz RC, "The relationship between insight and suicidality among patients with schizophrenia", J Nerv Ment Dis, 187, pp.376~378 (1999)
- Schwartz RC, "Insight and suicidality in schizophrenia: a replication study", J Nerv Ment Dis, 188, pp.235~237 (2000)
- Kim CH, "Hopelessness, neurocognitive function. insight in schizophrenia: relationship to suicidal behavior", Schizophr Res, 60, pp.71~80 (2003)
- Beck EM, "Are we addressing the ‘right stuff’ to enhance adherence in schizophrenia? Understanding the role of insight and attitudes towards medication", Schizophr Res, 132, pp.42~49 (2011)
