Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

Letter   |    
Medication Compliance
Virginia Aldigé Hiday, Ph.D.; Jeffrey W. Swanson, Ph.D.; H. Ryan Wagner, Ph.D.
Psychiatric Services 1999; doi:
text A A A

In Reply: Dr. Torrey correctly points out that our sample was involuntarily hospitalized and subsequently court-ordered to outpatient commitment, orders generally associated with noncompliance, and, furthermore, that our sample had a 71 percent noncompliance rate, as we reported in another article (reference 2 above). He concludes that these factors indicate "a direct relationship between medication noncompliance and criminal victimization."

It is possible that taking antipsychotic medication may reduce the risk of victimization by ameliorating symptoms such as disorientation, which might cause a severely mentally ill person to wander into dangerous areas, appear more vulnerable, and thus be criminally victimized, or by ameliorating symptoms such as annoying behavior, which might be provocative of abuse from acquaintances and friends. But we believe that the relationship between medication noncompliance and criminal victimization is more complicated.

Victimization reflects exposure to crime and violence in the social environment. Our analysis, along with the analyses of others who have looked at the problem, shows that victimization is associated with a constellation of problems such as alcohol abuse, drug dependence, homelessness, and mental disorder. Additionally, in our sample and in other samples of persons without mental disorders, victimization is associated with criminal and violent behavior.

Our second paper to which Dr. Torrey refers reported that medication noncompliance has a significant effect on violence only in interaction with substance abuse. As we suggest, medication noncompliance may lead to self-medicating with alcohol or drugs, and the subsequent impairment may impede medication adherence so that focusing on treatment of one without the other is unlikely to lead to effective reduction of violence and victimization. Problems of the social environment, such as homelessness, need to be addressed as well.




CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe

Related Content
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 21.  >
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 40.  >
Textbook of Psychotherapeutic Treatments > Chapter 5.  >
Textbook of Psychotherapeutic Treatments > Chapter 5.  >
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 24.  >
Topic Collections
Psychiatric News
PubMed Articles