J Korean Neuropsychiatr Assoc.  2020 May;59(2):159-165. 10.4306/jknpa.2020.59.2.159.

Attitude Toward Illness and Treatment in Adherent Schizophrenia Patients: A Qualitative Study

  • 1Department of Social Psychiatry and Rehabilitation, National Center for Mental Health, Seoul, Korea


The adherence to antipsychotics is essential for relapse prevention in schizophrenia. Although 40–60% of schizophrenia patients suffer from non-adherence problems, some patients had consistently good adherence. They are clinically desirable examples of non-adherent patients. This qualitative study aimed to explore the actors influencing medication adherence in people with schizophrenia with good adherence to the patients’ perspectives.
In-depth semi-structured interviews were conducted with 23 subjects with schizophrenia. Narratives were elicited on the attitudes toward illness and treatment, familiar support for treatment, and perceived stigma about psychosis over time.
In the process of changing from non-adherence to adherence, symptomatic relapse, involuntary treatment, and familial support played leading roles. The patients’ experiences on their own made them accept the illness and necessity of medications. Once the patients accepted the need for treatments, side effects and social stigma did not influence their adherence. Reducing psychotic symptoms was the priority of the treatment effects on the patients’ perspectives.
Adherence in schizophrenia requires multiple factors that affect the attitude toward illness and medication over time. Therefore, it is necessary to understand the specific process of adherence and develop the relevant interventions to facilitate those processes over time.


Schizophrenia; Adherence; Compliance; Attitude toward illness and medication; Qualitative study
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