The British Journal of Psychiatry (2006) 189: 508-514. doi: 10.1192/bjp.bp.105.019489
© 2006 The Royal College of Psychiatrists
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Adherence therapy for people with schizophrenia

European multicentre randomised controlled trial

RICHARD GRAY, RN, PhD, MORVEN LEESE, PhD and JONATHAN BINDMAN, MRCPsych, PhD

Health Services Research Department, Institute of Psychiatry, King’s College London, UK

THOMAS BECKER, MD

Department of Psychiatry II, University of Ulm, BKH Günzburg, Germany

LORENZO BURTI, MD

Department of Medicine and Public Health, Policlinico G.B. Rossi, Verona, Italy

ANTHONY DAVID, FRCPsych, MD

Section of Cognitive Neuropsychiatry

KEVIN GOURNAY, RN, PhD

Health Services Research Department, Institute of Psychiatry, King’s College London, UK

MARTIJN KIKKERT, MSc and MAARTEN KOETER, PhD

Academic Medical Center, Department of Psychiatry, University of Amsterdam, The Netherlands

BERND PUSCHNER, PhD

Department of Psychiatry II, University of Ulm, BKH Günzburg, Germany

AART SCHENE, MD, PhD

Academic Medical Center, Department of Psychiatry, University of Amsterdam, The Netherlands

GRAHAM THORNICROFT, FRCPsych, PhD

Health Services Research Department, Institute of Psychiatry, King’s College London, UK

MICHELE TANSELLA, MD

Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Italy.

Correspondence: Dr Richard Gray, Health Services Department, Institute of Psychiatry, King’s College London, De Crespigny Park, London SE5 8AF, UK.Tel.: +444 (0)20 7848 0139; fax: +44 (0)20 7848 0458; email: R.Gray{at}iop.kcl.ac.uk

Declaration of interest None. Funding detailed in Acknowledgements.

Background There is equivocal evidence of the effectiveness of adherence therapy in improving treatment adherence and clinical outcomes for people with schizophrenia.

Aims To evaluate the effectiveness of adherence therapy in improving quality of life for people with schizophrenia.

Method A 52-week, single-blind, multicentre randomised controlled trial of the effectiveness of adherence therapy. Participants were individually randomised to receive eight sessions of adherence therapy or health education. Assessments were undertaken at baseline and at 52-week follow-up.

Results Adherence therapy was no more effective than health education in improving quality of life.

Conclusions This effectiveness trial provides evidence for the lack of effect of adherence therapy in people with schizophrenia with recent clinical instability, treated in ordinary clinical settings.




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