Attitudes toward medication in inpatients with schizophrenia: A cluster analytic approach

Psychiatric Clinic, United Hospitals of Ancona and Polytechnic University of Marche, Via Conca, 60020 Ancona, Italy. <>
Psychiatry Research (Impact Factor: 2.47). 05/2008; 158(3):324-34. DOI: 10.1016/j.psychres.2006.12.010
Source: PubMed


Attitudes toward medication (ATM) exert an influential role on compliance. Ninety-nine inpatients with schizophrenia were administered the Rating of Medication Influences scale (ROMI). Patients were also rated using: i) the Health of the Nation Outcome Scales, ii) the Global Assessment of Functioning scale, iii) the Clinical Global Impression, Severity scale, and iv) the WHO Quality Of Life assessment, Brief Version. Seventy-seven subjects (77.8%) completed the ROMI interview. Cluster analysis identified the following four clusters: i) Ambivalence (n=17; 22%); ii) Problems with Patient, Family, Alliance (n=11; 14.3%); iii) Medication Affinity, Positive Influence from Others (n=30; 39%); and iv) Illness, Medication, Label Distress (n=19; 24.7%). Clusters did not differ in demographic or clinical variables except for depressed mood and physical well-being, which were, respectively, lower and higher in patients with mostly negative ATM. Based on rater assessment, psychotic symptoms were related to negative ATM independently of their severity, and the family played a central role in the expression of negative attitudes. ATM were relatively independent of clinical and psychosocial variables. The existence, in each cluster, of both external and inner motivations underpinning ATM suggests that therapeutic interventions must take into account both patients and their broader living contexts.

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    • "This could lead to more positive attitudes toward psychotropic medications among them.[25] However, other studies have found that even caregivers had a rather negative attitude toward pharmacological treatment of psychiatric disorders.[134748] In this case it has been proposed that this negative perception of caregivers derives from both public opinion and the media, which often support the view that psychotropic medications involve an element of coercion and cause harm.[13] "
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    ABSTRACT: Aim: To examine attitudes towards psychotropic medications among patients with chronic psychiatric disorders as well as their family caregivers by using factor analysis. Materials and Methods: The study included 200 patients and their family caregivers with chronic psychiatric disorders who are attending the psychiatry outpatient services. A self-designed 18-item self-rated questionnaire was used to evaluate the attitude toward psychotropics and factor analysis was done to study the different models of attitudes. Results: In general both patients and caregivers had positive attitude toward the psychotropic medications and there was no significant difference between the patients and caregivers on the various items of the questionnaire assessing the attitude. Factor analysis of the questionnaire indicated that either two-factor or four-factor models explained the attitude of the patients and caregivers. In the two-factor model there was one positive and one negative attitude factor, whereas the four-factor model comprised of two positive and two negative attitude factors. The four-factor model of attitudes provided a more comprehensive solution to how attitudes might be formed among patients and their family caregivers. Factors one and four in the four-factor solution still reflected positive attitudes, but appeared to portray a risk-benefit approach, in which benefits such as the efficacy of psychotropic medications in treating mental illnesses and preventing relapse, and medications being better than other options were being contrasted with the risks of side effects and permanent damage or harm. Conclusion: Attitudes of patients with chronic psychiatric disorders and their caregivers toward psychotropic medications appear to be shaped by factors such as perceived efficacy or benefit from medicines, the necessity for taking treatment and concerns such as side effects, harm or expense.
    Full-text · Article · Oct 2014
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    • "If this is the case, then a relative lack of adverse effects with newer drugs could result in higher levels of satisfaction and subjective well-being, but this remains to be proven [3,6,7]. The existence of both external and inner motivations underpinning the patients' attitudes towards medication and treatment in general suggests that any intervention needs to take into account both the disease and the person it afflicts, including his subjective experience, in a personalised way of treatment [8]. "
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    ABSTRACT: The 20-item Subjective Well-Being Under Neuroleptic Treatment Scale (SWN-20) is a self-report scale developed in order to assess the well-being of patients receiving antipsychotic medication independent of the improvement in their psychotic symptoms. The current study reports on the reliability and the psychometric properties of the Greek translation of the SWN-20. A total of 100 inpatients or outpatients with schizophrenia (79 males and 21 females, aged 42.6 +/- 11.35 years old) from 3 different facilities were assessed with the Positive and Negative Symptoms Scale (PANSS), the Calgary Depression Scale and the Simpson-Angus Scale, and completed the SWN-20. The statistical analysis included the calculation of Pearson product moment correlation coefficient, the Cronbach alpha and factor analysis with Varimax normalised rotation. The SWN-20 had an alpha value equal to 0.79 and all the items were equal. The factor analysis revealed the presence of seven factors explaining 66% of total variance. The correlation matrix revealed a moderate relationship of the SWN-20 and its factors with the PANSS-Negative (PANSS-N), PANSS-General Psychopathology (PANSS-G), the Simpson-Angus and the Calgary scales, and no relationship to age, education and income class. The Greek translation of the SWN-20 is reliable, with psychometric properties close to the original scale.
    Full-text · Article · Feb 2009 · Annals of General Psychiatry
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