Chronically ill adolescents. Compliance and psychological symptoms

Background. Adherence to treatment in chronically ill adolescents is often classified as low. This article discusses the extent to which adherence is connected with psychological symptoms. Materials and Methods. During rehabilitation treatment, data were collected from 179 chronically ill adolescents between 13.5 and 19.0 years old and their 127 medical practitioners. For identification of psychological symptoms, the SPS-J ("Screening Psychischer Storungen im Jugendalter"; Screening of Psychological Disturbances in Adolescence) tool was used. The MOS Compliance Scale was chosen to measure adherence. Results. For patient-reported outcomes, significant negative correlations were found between adherence and the scales for anger control problems (r=-0.165; p=.043) and self-esteem problems (r=-0.210; p=.009). For externally reported outcomes, significant negative correlations were also found between adherence and the scales for antisocial behavior (r=-0.214; p=.015), anger control problems (r=-0.281; p=.001), anxiety/depression (r=-0.197; p=.026), and self-esteem problems (r=-0.182; p=.039). Conclusions. Psychological symptoms may accompany decreased adherence. Physicians should recognize psychological symptoms and, if necessary, initiate further diagnostic investigation.