Zakal K. Medication compliance in paranoid schizophrenia (clinical-psychopathological and psychosocial factors, diagnosis, correction)

In the dissertation clinical peculiarities of a good and a poor medication compliances (MC) in patients with paranoid schizophrenia (PS) of continuous (CC), episodic (EC) and remittent (RC) courses and their main clinical-psychopathological, individual-psychological and psychosocial factors of formation have been studied. To achieve the aim of the dissertation, 202 patients with CC, EC, and RC PS (F 20.0) were examined. Groups of patients with different MC levels were defined among patients with various types of PS course. Clinical-psychopathological correlates of a good and a poor MCs were investigated in different types of PS course. On the base of the analysis of MC impairments in patients with PS, new data about mechanisms of MC impairments in this pathology were obtained, taking into account factors of an attitude to a physician and medication, a realizing of the disease (insight), a social environment, and therapeutic alliance. It was performed a detailed study of individual-psychological and social-psychological determinants (patients' personality traits, a psychosocial adjustment, a social functioning, and quality of life) influencing on impairments of adherence to therapy in patients with PS with different variants of course and psychopathological symptoms. In the study a level of a suicidal risk in patients with paranoid schizophrenia and different MC levels was investigated. On the basis of data obtained it was worked out and implemented the system of medical and psychosocial technologies for MC improvement in patients with different courses and psychopathological symptoms in paranoid schizophrenia.