Pharmacopsychiatry 2005; 38(3): 107-112
DOI: 10.1055/s-2005-864119
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Pharmacophilia and Pharmacophobia: Determinants of Patients’ Attitudes towards Antipsychotic Medication

I. Sibitz1 , H. Katschnig1 , 2 , R. Goessler2 , A. Unger1 , M. Amering1
  • 1Department of Psychiatry, Medical University of Vienna
  • 2Ludwig Boltzmann Institute of Social Psychiatry, Vienna
Further Information

Publication History

Received: 10.4.2004 Revised: 26.7.2004

Accepted: 2.9.2004

Publication Date:
18 May 2005 (online)

Objective: To identify factors that influence attitudes towards psychopharmacological treatment in patients suffering from schizophrenia and schizoaffective psychoses. Methods: Ninety-two participants in an outpatient psychoeducational program, classed as ”pharmacophobic” or ”pharmacophilic” according to the Drug Attitude Inventory scale, were compared with regard to sociodemographic variables, clinical characteristics, subjective deficit syndrome, illness concepts, knowledge, locus of control, and quality of life. Results: The 59 pharmacophilic and the 33 pharmacophobic patients did not differ significantly with regard to most sociodemographic variables, symptoms, or classic personality traits such as locus of control, self-concept, and quality of life. The only differences concerned hospitalization history (P < 0.05) and statements on the actual, subjective experience of desired and undesired effects of medication (P < 0.01). Conclusions: The impact of subjective experiences with drug treatment on attitudes towards medication and compliance needs to be a main focus of interventions targeting attitudes towards pharmacological treatment.

References

  • 1 Amering M, Katschnig H. Psychopharmaka im Spannungsfeld zwischen Patienten, Angehörigen und Betreuern. In: Platz T (Ed.) Brennpunkte der Schizophrenie - Gesellschaft-Angehörige-Therapie. Springer-Verlag Wien New York; 1993: 223-231
  • 2 Angermeyer M C, Matschinger H. Public attitudes towards psychotropic drugs: have there been any changes in recent years?.  Pharmacopsychiatry. 2004;  37 152-156
  • 3 Awad A G. Subjective response to neuroleptics in schizophrenia.  Schizophr Bull. 1993;  19 609-618
  • 4 Bäuml J, Pitschel-Walz G, Kissling W. Psychoedukative Gruppen bei schizophrenen Psychosen: Spezifische Auswirkungen eines bifokalen Ansatzes auf Krankheitsbewältigung und Rezidivraten im 4-Jahreszeitraum. Ergebnisse der Münchner PIP-Studie. In: Dittmar V, Klein HE, Schön D, eds Die Behandlung schizophrener Menschen. Integrative Therapiemodelle und ihre Wirksamkeit. S. Roderer Verlag Regensburg; 1997: 169-195
  • 5 Bitter I, Chou J C-Y, Ungvari G S, Tang W K, Xiang Z, Iwanami A, Gaszner P. Prescribing for inpatients with schizophrenia: an international multi-center comparative study.  Pharmacopsychiat. 2003;  36 143-149
  • 6 Cabeza I G, Amador M S, Lopez C A, Gonzalez de Chavez M. Subjective response to antipsychotics in schizophrenic patients: clinical implications and related factors.  Schizophr Res. 2000;  41 349-355
  • 7 Croghan T W, Tomlin M, Pescosolido B A, Schnittker J, Martin J, Lubelle K eri, Swindle R. American attitudes toward and willingness to use psychiatric medications.  J Nerv Ment Dis. 2003;  191 166-174
  • 8 Dolder C R, Lacro J P, Dunn L B, Jeste D V. Antipsychotic medication adherence: is there a difference between typical and atypical agents?.  Am J Psychiatry. 2002;  159 103-108
  • 9 Draine J, Solomon P. Explaining attitudes toward medication compliance among a seriously mentally ill population.  J Nerv Ment Dis. 1994;  82 50-54
  • 10 Fenton W S, Blyler C R, Heinssen R K. Determinants of medication compliance in schizophrenia: empirical and clinical findings.  Schizophr Bull. 1997;  23 637-651
  • 11 Gervin M, Browne S, Garavan J, Roe M, Larkin C, O'Callaghan E. Dysphoric subjective response to neuroleptics in schizophrenia: relationship to extrapyramidal side effects and symptomatology.  Eur Psychiatry. 1999;  14 405-409
  • 12 Grohmann R, Engel R R, Geissler K H, Rüther E. Psychotropic drug use in psychiatric inpatients: recent trends and changes over time - data from the AMSP study.  Pharmacopsychiatry. 2004;  37 Suppl 1 S27-38
  • 13 Hiller W, Zaudig M, Mombour W. IDCL/ICD 10 International Diagnostic Checklists. IDCL Internationale Diagnosen Checklisten für ICD-10 und DSM-IV. Verlag Huber Bern; 1995
  • 14 Hofer A, Kemmler G, Eder U, Honeder M, Hummer M, Fleischhacker W W. Attitudes toward antipsychotics among outpatient clinic attendees with schizophrenia.  J Clin Psychiatry. 2002;  63 49-53
  • 15 Hogan T P, Awad A G, Eastwood R. A self-report scale predictive of drug compliance in schizophrenia: reliability and discriminative ability.  Psychol Med. 1983;  13 177-183
  • 16 Holzinger A, Löffler W, Müller P, Priebe S, Angermeyer M C. Subjective illness theory and antipsychotic medication compliance by patients with schizophrenia.  J Nerv Ment Dis. 2002;  190 597-603
  • 17 Jaeger J, Bitter I, Czobor P, Volavka J. The measurement of subjective experience in schizophrenia: The Subjective Deficit Syndrome Scale.  Compr Psychiatry. 1990;  31 (3) 216-226
  • 18 Jorm A F. Mental health literacy. Public knowledge and beliefs about mental disorders.  Br J Psychiatry. 2000;  177 396-401
  • 19 Kampman O, Lehtinen K. Compliance in psychoses.  Acta Psychiatr Scand. 1999;  100 167-175
  • 20 Kay S R, Fiszbein A, Opler L A. The positive and negative syndrome scale (PANSS) for schizophrenia.  Schizophr Bull. 1987;  13 (2) 261-276
  • 21 Keith S J, Kane J M. Partial compliance and patient consequences in schizophrenia: our patients can do better.  J Clin Psychiatry 2003;. 64;  11 1308-1315
  • 22 Kemp R, Kirov G, Everitt B, Hayward P, David A. Randomised controlled trial of compliance therapy. 18-month follow-up.  Br J Psychiatry. 1998;  172 413-419
  • 23 Krampen G. FKK, Fragebogen zu Kompetenz- und Kontrollüberzeugungen (Competence and Control Orientations Questionnaire). Hogrefe Göttingen; 1991
  • 24 Lambert M, Graf Schimmelmann B, Karow A, Naber D. Subjective well-being and initial dysphoric reaction under antipsychotic drugs - concepts, measurement and clinical relevance.  Pharmacopsychiat. 2003;  36 (suppl 3) S181-S190
  • 25 Lauber C, Nordt C, Falcato L, Rossler W. Lay recommendations on how to treat mental disorders.  Soc Psychiatry Psychiatr Epidemiol. 2001;  36 553-556
  • 26 Linden M, Nather J, Wilms H U. Definition, significance and measurement of illness concepts of patients. The Illness Concept Scale (KK-scale) for schizophrenic patients.  Fortschr Neurol Psychiatr. 1988;  56 35-43
  • 27 Löffler W, Kilian R, Toumi M, Angermeyer M C. Schizophrenic patients' subjective reasons for compliance and noncompliance with neuroleptic treatment.  Pharmacopsychiat. 2003;  36 105-112
  • 28 Lohaus A, Schmitt G M. KKG (Multidimensional Health Locus of Control Scale (MHLC; Wallston, K.A., Wallston, B.S., & DeVellis, R., 1978) - German modified version). Hogrefe Göttingen; 1989
  • 29 McCue R E, Waheed R, Urcuyo L. Polypharmacy in patients with schizophrenia.  J Clin Psychiatry. 2003;  64 984-989
  • 30 Mezzich J E, Ruiperez M A, Perez C, Yoon G, Liu J, Mahmud S. The Spanish version of the quality of life index. presentation and validation.  J Nerv Ment Dis. 2000;  188 (5) 301-5
  • 31 Noordsy D L, Torrey W C, Mead S, Brunette M, Potenza D, Copeland M E. Recovery-oriented psychopharmacology: redefining the goals of antipsychotic treatment.  J Clin Psychiatry. 2000 ;  61 (suppl 3) 22-29
  • 32 O'Donnell C, Donohoe G, Sharkey L, Owens N, Migone M, Harries R, Kinsella A, Larkin C, O'Callaghan E. Compliance therapy: a randomised controlled trial in schizophrenia.  BMJ. 2003;  327 (7419) 834
  • 33 Procyshyn R M, Thompson B. Patterns of antipsychotic utilization in a tertiary care psychiatric institution.  Pharmacopsychiatry. 2004;  37 12-17
  • 34 Rettenbacher M A, Burns T, Kemmler G, Fleischhacker . Schizophrenia: attitudes of patients and professional carers towards the illness and antipsychotic medication.  Pharmacopsychiatry. 2004;  37 103-109
  • 35 Rossi A, Arduini L, Stratta P, Pallanti S. Subjective experience and subjective response to neuroleptics in schizophrenia.  Compr Psychiatry. 2000;  41 446-449
  • 36 Ruscher S M, de Wit R, Mazmanian D. Psychiatric patients' attitudes about medication and factors affecting noncompliance.  Psychiatr Serv. 1997;  48 82-85
  • 37 Zygmunt A, Olfson M, Boyer C A, Mechanic D. Interventions to improve medication adherence in schizophrenia.  Am J Psychiatry. 2002;  159 1653-1664

Ingrid Sibitz, M.D.

Department of Psychiatry

Medical University of Vienna

Währinger Gürtel 18-20

A-1090 Vienna

Phone: 0043/1/40400-3546

Fax: 0043/1/40400-3605

Email: Ingrid.Sibitz@meduniwien.ac.at