Schizophrenia is a psychotic disorder that can affect all aspects of a patient’s life and lead to suicide (APA, 2013). Because of this, psychiatrists often prescribe antipsychotic medications to treat symptoms (Chien, Mui, Gray, & Cheung, 2016). However, many patients do not adhere to the prescribed treatment, resulting in a multitude of problems including recurrence of symptoms and hospitalization (MacEwan et al., 2016). Adherence therapy is a form of psychotherapy in which patients discuss their feelings about their mental illness, treatment, and life (Chein et al, 2016). Adherence therapy is an effective addition to the medical treatment of schizophrenia because it results in improved outcomes for patients.
Schizophrenia is characterized by two or more of the following symptoms over course of a six-month period (APA, 2013). One symptom must be delusions, hallucinations, or disorganized speech and the second symptom could be one of these, or disorganized or catatonic behavior, or negative symptoms (APA, 2013). Each symptom must last for a minimum of one month (APA, 2013). Delusions are false beliefs that cannot be changed, even with contradictory evidence; hallucinations occur when someone senses something that is not actually present; disorganized speech occurs when someone communicates in a way that is incomprehensible to others; disorganized behavior is behavior that is abnormal, including acting childish or extremely agitated. Catatonic behavior shows a low reactivity to the environment; negative symptoms are diminished symptoms including decreased expression of emotion and decreased activity (APA, 2013). Men typically develop symptoms in their early 20s and females in their late 20s (APA, 2013). Genetic factors play a role in schizophrenia risk, but specific genes have not been identified (APA, 2013). Very few people fully recover from this disorder and there is a high suicide risk of five to six percent (APA, 2013). Oral antipsychotics are a common treatment for people diagnosed with schizophrenia, however many people fail to adhere to their prescribed treatment (MacEwan et al., 2016). Despite advances in antipsychotics, which have reduced negative side effects, adherence rates are still abysmal at 30-50% (Chein et al., 2016). This is an issue because failure to follow treatment can lead to recurrences, relapses, and hospitalization, all of which are expensive for private insurance companies and Medicare/Medicaid (MacEwan et al., 2016). Some reasons people cite for failing to adhere include stigma, adverse drug reactions, poor insight, memory problems, and lack of social support (Anderson et al., 2010). MacEwan, Forma, Shafrin, Hatch, Lakdawalla, and Lindenmayer performed a study examining adherence patterns in schizophrenics in the United States using Medicare, Medicaid, and private insurance company databases (MacEwan et al., 2016). They found that 33.2% of patients were adherent after 1 year, 15.0% discontinued treatment after 3 months, 6.5% after 6 months, 5.1% after 9 months, 15.3% who would repeatedly stop and then start treatment after 6 months, and 24.9% who immediately discontinued treatment (MacEwan et al., 2016). Younger patients, those who abused alcohol and drugs, and those with multiple mental illness were less likely to adhere to the treatment plan (MacEwan et al., 2016). One strength of this study was that it used databases, which lessened ethical concerns and allowed for a large sample of 29,607 participants, which is a relatively large size for a schizophrenia study (MacEwan et al., 2016). However, one drawback is the sampling technique which looked at Medicare, Medicaid, and privately insured patients, but failed …show more content…
Half of the patients received adherence therapy once a week for eight weeks and these patients showed a 22% decline in positive symptoms at the end of this time period (Anderson et al., 2010). Additionally, when asked about their experiences, 83% of those in the adherence therapy group indicated that they had learned how to better manage their mental health (Anderson et al., 2010). However, one weakness of the study was that the researchers were only able to include 26 patients in the study, due to lack of interest of many potential participants and their inability to provide informed consent (Anderson et al., 2010). It was also determined that the participants in the sample initially had a high baseline adherence, compared to the average rates of adherence for schizophrenic patients (Anderson et al., 2010). This indicates a potential source of error as these positive results may have differed with schizophrenics with low baseline
Schizophrenia is characterized by two or more of the following symptoms over course of a six-month period (APA, 2013). One symptom must be delusions, hallucinations, or disorganized speech and the second symptom could be one of these, or disorganized or catatonic behavior, or negative symptoms (APA, 2013). Each symptom must last for a minimum of one month (APA, 2013). Delusions are false beliefs that cannot be changed, even with contradictory evidence; hallucinations occur when someone senses something that is not actually present; disorganized speech occurs when someone communicates in a way that is incomprehensible to others; disorganized behavior is behavior that is abnormal, including acting childish or extremely agitated. Catatonic behavior shows a low reactivity to the environment; negative symptoms are diminished symptoms including decreased expression of emotion and decreased activity (APA, 2013). Men typically develop symptoms in their early 20s and females in their late 20s (APA, 2013). Genetic factors play a role in schizophrenia risk, but specific genes have not been identified (APA, 2013). Very few people fully recover from this disorder and there is a high suicide risk of five to six percent (APA, 2013). Oral antipsychotics are a common treatment for people diagnosed with schizophrenia, however many people fail to adhere to their prescribed treatment (MacEwan et al., 2016). Despite advances in antipsychotics, which have reduced negative side effects, adherence rates are still abysmal at 30-50% (Chein et al., 2016). This is an issue because failure to follow treatment can lead to recurrences, relapses, and hospitalization, all of which are expensive for private insurance companies and Medicare/Medicaid (MacEwan et al., 2016). Some reasons people cite for failing to adhere include stigma, adverse drug reactions, poor insight, memory problems, and lack of social support (Anderson et al., 2010). MacEwan, Forma, Shafrin, Hatch, Lakdawalla, and Lindenmayer performed a study examining adherence patterns in schizophrenics in the United States using Medicare, Medicaid, and private insurance company databases (MacEwan et al., 2016). They found that 33.2% of patients were adherent after 1 year, 15.0% discontinued treatment after 3 months, 6.5% after 6 months, 5.1% after 9 months, 15.3% who would repeatedly stop and then start treatment after 6 months, and 24.9% who immediately discontinued treatment (MacEwan et al., 2016). Younger patients, those who abused alcohol and drugs, and those with multiple mental illness were less likely to adhere to the treatment plan (MacEwan et al., 2016). One strength of this study was that it used databases, which lessened ethical concerns and allowed for a large sample of 29,607 participants, which is a relatively large size for a schizophrenia study (MacEwan et al., 2016). However, one drawback is the sampling technique which looked at Medicare, Medicaid, and privately insured patients, but failed …show more content…
Half of the patients received adherence therapy once a week for eight weeks and these patients showed a 22% decline in positive symptoms at the end of this time period (Anderson et al., 2010). Additionally, when asked about their experiences, 83% of those in the adherence therapy group indicated that they had learned how to better manage their mental health (Anderson et al., 2010). However, one weakness of the study was that the researchers were only able to include 26 patients in the study, due to lack of interest of many potential participants and their inability to provide informed consent (Anderson et al., 2010). It was also determined that the participants in the sample initially had a high baseline adherence, compared to the average rates of adherence for schizophrenic patients (Anderson et al., 2010). This indicates a potential source of error as these positive results may have differed with schizophrenics with low baseline