Problem wspó pracy w leczeniu chorych z zaburzeniami l kowymi

Anxiety disorders are a serious problem in bothpsychiatric practice and research, affecting about 20%of the general population. This paper highlights theproblem of interactions between quality of treatmentcompliance and the course of anxiety disorders, as wellas the outcomes of therapy.There is a general scarcity of data concerning compliancein anxiety disorders, and coherence of the availableevidence is not a rule. Everyday clinical experiencesuggests that compliance among patients with anxietydisorders is generally satisfactory (the validity of thisstatement is supported by the results of some trials), butsome data indicate that up to 50% of patients belongingto this group are at risk of treatment drop-out. Dropoutrates are higher among people receiving psycho -therapy in outpatient settings than among inpatients.Published evidence indicates that the quality ofcompliance is positively correlated with the outcomesof cognitive-behavioural therapy of panic disorder; theanalogous data regarding obsessive-compulsive disorder,social anxiety disorder and generalized anxiety disorderare unclear. Various authors advocate psychoeducation(regardless of the type of disorder) as the best way ofenhancing compliance, as ‘knowledge is an importantfactor in change’.Compliance with antidepressant treatment seems to beunsatisfactory. Side effects are the most frequent reasonfor discontinuing or switching antidepressants. Patientswith comorbid depressive disorders seem to be morecompliant with pharmacotherapy.