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psychoneuro 2006; 32(6): 313-318
DOI: 10.1055/s-2006-948217
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© Georg Thieme Verlag Stuttgart · New York

Prävention und Behandlung von Non-Compliance und Gesamtbehandlungsabbruch

Prevention and treatment of Non-Compliance and dropping outKristin Rabovsky1 , Gabriela Stoppe1
  • 1Universitäre Psychiatrische Kliniken Basel
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Publication History

Publication Date:
04 July 2006 (online)

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In der Behandlung Schizophrenieerkrankter ist Non-Compliance ein wesentlicher Faktor für einen ungünstigeren individuellen Verlauf, vermehrte Angehörigenbelastung und höhere sozioökonomische Kosten. Während Publikationen über Gesamtbehandlungsabbrüche insbesondere auf die Bedeutung von Therapiekontinuität hinweisen, bestätigt die umfangreiche Literatur über andere Aspekte von Non-Compliance Prädiktoren wie ein schwaches therapeutisches Bündnis, mangelnde Krankheitseinsicht und subjektiv unangenehm empfundene Medikamenten(neben)wirkungen. Erfolgreiche Strategien zur Complianceverbesserung und Prävention von Therapieabbrüchen umfassen versorgungsstrukturelle und „-kulturelle” Aspekte, individuelle Maßnahmen und therapeutisch v.a. kognitiv-behaviorale und multimodale Ansätze. Im Hinblick auf nachhaltig wirksame Gesamtbehandlungskonzepte ist die Weiterentwicklung compliancefördernder Maßnahmen essenziell.

In the treatment of schizophrenia, non-compliance is an essential factor, leading to a more unfavourable individual course of the disease as well as to increased relatives' burden and higher socio-economic costs. While studies on dropping out of treatment stress the importance of continuity of care, the comprehensive literature on predictors of non-compliance confirms correlates like weak therapeutic alliance, poor insight and subjective disagreeable medication (side-)effects. Successful strategies to enhance compliance include specific service policies, individual measures and cognitive-behavioural and multimodal concepts as most effective therapeutic approaches. Considering sustaining treatment concepts the further development of compliance-enhancing strategies is essential.

Key Words

Schizophrenia - compliance - adherence - concordance - drop-out - continuity

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Korrespondenzadresse:

Dr. med. Kristin Rabovsky
Prof. Dr. med. Gabriela Stoppe

Universitäre Psychiatrische Kliniken Basel

Wilhelm-Klein-Str. 27

CH - 4025 Basel

Email: kristin.rabovsky@upkbs.ch

Email: gabriela.stoppe@upkbs.ch

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