Improvement of patient attitude toward treatment among inpatients with schizophrenia and its related factors: Controlled study of a psychological approach

Abstract 

A randomized controlled trial was conducted in an acute inpatient setting to test the effects of an intervention based on individual interviews, with the goal to improve patients' attitudes towards their psychiatric situation and understanding of illness and its treatment. In addition, the factors related to the improvement were explored. Fifty eligible male patients with DSM-IV schizophrenia recruited from consecutive admissions were allocated to two groups: weekly sessions plus routine inpatient treatment or routine inpatient treatment only. Assessment was conducted twice, before and after the maximum 8-week intervention period. The assessment included a self-report scale for measuring patients' psychological attitudes toward their treatment situation, scales of therapist perception and self-perception applying a semantic differential technique, and the Maudsley Personality Inventory (MPI), in addition to assessment of psychotic symptomatology. We found a modest but significant effect of the intervention on one domain of patient attitude: recognition of need for treatment. Trust of patients in their psychiatrist was a factor for improvement of the recognition domain. Neuroticism had some influence on the formation of personal relations in a psychiatric situation. This study lends support to the effectiveness of psychological treatment on patient attitude, and indicates some factors related to its development.

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