Abstract
INTRODUCTION: The limited practice of depot antipsychotics and psychoeducation use, recommended for overcoming the noncompliance of patients with severe mental disorders, is linked to a high incidence of treatment violation. Therefore, the development of personalized mental healthcare approaches is a crucial healthcare task.
 AIM: To describe and differentiate the role of clinical, social and psychological factors that lead to different level of treatment engagement of psychiatric inpatients.
 METHODS: Secondary analysis of findings from 91 inpatients, based on the Treatment Motivation Assessment Questionnaire and Medication Compliance Scale, as well as the Scale of Internalized Stigma of Mental Illness and Perceived Discrimination and Devaluation Scale. Factorial analysis, cluster analysis and analysis of variance with p-level=0.05 and the calculation of the effect size (ES) according to Cohens d and Cramers V were used.
 RESULTS: The nature of therapy compliance in various categories of patients is mediated differentially, including: the severity of negative symptoms (ES=0.29), the global level of functioning and work maladjustment (ES=0.230.26), various motivational and behavioral styles (ES0.74) and the intensity of psychiatric stigmatization (ES0.88).
 CONCLUSIONS: Consideration of the clinical, social and psychological factors should empirically determine the strategies for the personalized use of prolonged antipsychotics and socio-psychotherapeutic interventions when developing an individual treatment plan for psychiatric in-patients.
Highlights
The limited practice of depot antipsychotics and psychoeducation use, recommended for overcoming the noncompliance of patients with severe mental disorders, is linked to a high incidence of treatment violation
Consideration of the clinical, social and psychological factors should empirically determine the strategies for the personalized use of prolonged antipsychotics and socio-psychotherapeutic interventions when developing an individual treatment plan for psychiatric in-patients
The purpose of the study is a differentiated description of the role of clinical and socio-psychological factors involved in the formation of different levels of in-patient engagement in the treatment process
Summary
The limited practice of depot antipsychotics and psychoeducation use, recommended for overcoming the noncompliance of patients with severe mental disorders, is linked to a high incidence of treatment violation. The traditional approach to achieving high adherence to treatment in patients with severe mental disorders is the widest possible use of depot antipsychotics. Among the barrier factors for the widespread use of depot drugs in clinical work are organizational factors (a limited number of drugs paid for from insurance funds due to a high cost for depot antipsychotics), the doctorsattitude (difficulties in dose control, subjective perception of the appointment as coercion of the patient, established clinical practice), or factors related to the patient, such as a fear of painful injections, lack of information or perception of depot therapy as a coercive measure.[3] At the same time, an analysis of the frequency of prolongedrelease antipsychotics use indicates their predominant prescription in situations of clinical uncertainty: among 37.8% of patients with polypharmacy,[4] as well as among those with increased aggressiveness[5] and those who rarely seek in-patient care.[6] At the same time, the question remains unclear whether such categories of patients benefit the most from the depot therapy. Some clinical recommendations indicate the validity of using depot drugs for the treatment of severe patients, and as a choice for routine antirelapse therapy.[7]
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