[Therapeutic treatment with neuroleptics. II: Subjective mechanisms of effect, compliance and consequences for treatment strategy]

Abstract

The problems of subjective acceptance and reaction by the patients to the effects produced by neuroleptics, have been receiving far more less attention so far than the "objective" aspects, and have not yet been empirically tested to the same extent. However, papers have been published recently in connection with this complex within the framework of researches into concept of disease and into compliance. These papers supply proof of the tremendous significance of the patient's attitude to, and assessment of, pharmacotherapeutic measures. The following aspects are pointed out to be particularly important: The attitude and relation of the patient to his psychosis; the style of coping in the sense of integration or disintegration of the psychosis into the process of life; the dysphoric reactions to neuroleptics; and the disease pattern or disease model. Practical model examples are given to illustrate three possibilities of a more intensive connection between neuroleptic therapy and other therapeutic measures.