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I have a friend, who has a child ( who is about 12-13 years old) who is diagnosed with schizophrenia and bipolar symptom. Now, dealing with a child who can't think straightly and suffer from hallucinations is very different from dealing with other normal kids.

We understand that taking medicine is very important for the child to get well again. But usual reasoning with the child won't do. We also contemplate to use brute force to use medicine on him. But this is not very good, plus we lack the will to do that.

What should we do in this case?

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How old is the child? Answers would probably be very different from four years and twelve years. –  Torben Gundtofte-Bruun Jul 8 '13 at 7:08
    
About 12-13 years old –  Graviton Jul 8 '13 at 7:24
    
Can this conceivably be delivered in stealth, perhaps through food or drink? –  Tim Post Jul 10 '13 at 11:00
    
@TimPost, nope. For some reasons, schizophrenia kids are extremely alerted, all the time. –  Graviton Jul 10 '13 at 13:12

1 Answer 1

Medication noncompliance is an issue with about 70% of schizophrenic patients. There are a number of reasons for this, including:

  • Lack of awareness (I'm not sick, so why should I take medication?). This is biological.
  • Denial (patient knows he is sick but refuses to believe it). This is psychological.
  • Side effects which doctors often underestimate.
  • Delusions of grandeur (I'm all powerful so I don't need medication).
  • Delusions of paranoia (You are trying to poison me).
  • Fears of dependency or addiction.
  • Perception of a stigma attached to the medication.
  • The medication removes delusions, and makes the patient feel less important.

To encourage compliance, it helps if you can figure out what is causing the noncompliance. Some ideas to consider:

  • The patient needs to understand why it is important to take medication. Try to tie it to a desired outcome. If you want to get to [go to the mall, hang out with friends, ride your bike, stay at home instead of the hospital] you need to take your medication to make sure your stay well to do that thing.
  • Pill containers with compartments simplify drug-taking.
  • Medication can be taken via injection, which assures compliance to a greater degree - some injectable medications are longlasting and only have to be take once or twice a week.
  • Make sure the doctor listens to any complaints of side effects.
  • Bribery.
  • Meeting peers with the same condition.
  • Education - teach the child about the disease through books and videos.

Sources:

Torrey, E. Fuller. Surviving Schizophrenia: A Manual for Families, Patients, and Providers

Francell, Terry G., Jr. "Medication: The Foundation of Recovery." Treatment Advocacy Center

Born Schizophrenic: Jani's World Discovery Channel Series

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