조현병 환자의 클로자핀 복용지속에 영향을 미치는 요인: 질적 연구

• 영문명: Factors Affecting Clozapine Adherence in Patients With Schizophrenia: A Qualitative Study
• 발행기관: 대한신경정신의학회
• 저자명: 최성문 백명재 강원섭 이아라 백종우 이상민
• 간행물 정보: 『신경정신의학』제64권 제4호, 277~288쪽, 전체 12쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2025.11.30

국문 초록

Objectives: This study examined the psychosocial factors that influence the continuation of clo\-zapine use among individuals with schizophrenia. This examination was conducted through in-depth qualitative interviews. Methods: Thirty-one adults diagnosed with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) who had been taking Clozapine® for at least 3 months were inter\-viewed. Data were collected from May to October 2024 and analyzed using Braun and Clarke’s thematic analysis. Results: Two overarching themes emerged: 1) transformation of perceptions and engagement with treatment, including initial resistance stemming from severe symptoms and lack of insight, experiences of coercive interventions, rebuilding trust in the mental health system, and evolving attitudes toward psychiatric medications; and 2) personal recovery and social support, encom\-passing coping with side effects, recognizing symptom improvement and renewed hope, and the pivotal roles of family and therapeutic alliance. Trust in healthcare providers and emotional support from family were central to sustained adherence to clozapine. Conclusion: Sustained clozapine use in schizophrenia patients is influenced by intertwined psy\-chological, relational, and contextual factors. Acceptance of treatment was supported by symp\-tom improvement, family support, and trust in healthcare providers. These elements contributed to medication adherence and broader functional recovery. A person-centered, integrated ap\-proach is essential to promote continued use and long-term outcomes.

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키워드

Schizophrenia Clozapine Psychosocial factors Professional-patient relations Qualitative research