Review article
Compliance in anxiety disorders

Anxiety disorders are a serious problem in both psychiatric practice and research, affecting about 20% of the general population. This paper highlights the problem of interactions between quality of treatment compliance and the course of anxiety disorders, as well as the outcomes of therapy.

There is a general scarcity of data concerning compliance in anxiety disorders, and coherence of the available evidence is not a rule. Everyday clinical experience suggests that compliance among patients with anxiety disorders is generally satisfactory (the validity of this statement is supported by the results of some trials), but some data indicate that up to 50% of patients belonging to this group are at risk of treatment drop-out. Drop-out rates are higher among people receiving psychotherapy in outpatient settings than among inpatients. Published evidence indicates that the quality of compliance is positively correlated with the outcomes of cognitive-behavioural therapy of panic disorder; the analogous data regarding obsessive-compulsive disorder, social anxiety disorder and generalized anxiety disorder are unclear. Various authors advocate psychoeducation (regardless of the type of disorder) as the best way of enhancing compliance, as ‘knowledge is an important factor in change’.

Compliance with antidepressant treatment seems to be unsatisfactory. Side effects are the most frequent reason for discontinuing or switching antidepressants. Patients with comorbid depressive disorders seem to be more compliant with pharmacotherapy.