Compliance in first psychotic episode: acceptation, refusal or process?
Poster A126, Thursday, October 20, 11:30 am - 1:00 pm, Le Baron
Laurence Artaud1, Amal Abdel-Baki1, Cécile Rousseau2; 1Université de Montréal, 2Université McGill
Objective: Quantitative studies have documented the extent of compliance issues in early psychosis and the ensuing clinical consequences. However, an in-depth understanding of this phenomenon remains limited. Drawing upon the perspectives of a sample of patients, their families, and clinicians, this study explores why patients suffering from early-stage psychosis accept or refuse treatment. Method: Data collection was conducted using semi-structured individual interviews with 18 patients from a clinic specializing in early psychosis who were identified as compliant, ambivalent or non-compliant. In addition, interviews were conducted with 13 of their family members, as well as a focus group composed of 8 clinicians working at the clinic. Results: For the majority of patients, compliance appeared to evolve according to a process characterized by varying degrees of ambivalence. In particular, identity issues, relational issues, the understanding of the diagnosis, and the meaning of treatment were key to understanding patients’ sense of ambivalence. Conclusion: Ambivalence and non-compliance can be seen as normal stages of a process whereby the patient struggles to rebuild his or her sense of self and constructs their ongoing identity. A relationship of trust may facilitate a gradual resolution of the ambivalence, promoting a patient’s sense of ownership and empowerment in the context of treatment. Key words: schizophrenia; bipolar disorder; compliance; first-episode psychosis; qualitative research
Topic Area: Psychosocial Interventions