Current Research on Suicide and Parasuicide: Selected Proceedings of the Second European Symposium on Suicidal Behaviour, Edinburgh, June 1988

H. J. MÖLLER

The problem of compliance is currently being considered more frequently and more thoroughly in the fields of medical care and psychotherapy; in the latter regard, this problem appears to be of special interest in the area of suicide prevention ( Kurz and Möller, 1984).

From research work in psychotherapy and drug therapy we know some relevant background factors affecting compliance ( Graupe, 1975; Linden, 1979). Based on these results we should keep in mind that compliance with therapy is a very complex phenomenon, constituted mainly by the triangle of patient, therapist, and therapy. In addition, institutional and other aspects have to be considered. With respect to the patient, the following variables, among others, seem to be relevant: social class, personality traits, insight into illness or problems, whether suffering from illness, information about therapy, expectations about therapy, experiences during the therapeutic sessions, and experiences from former psychotherapy. As to the therapist: social class, personality traits, theoretical background, type and duration of psychotherapeutic education, duration of working as psychotherapist, etc., are of importance.

Based on clinical evidence, it can be concluded that suicidal patients, especially those who have just attempted suicide, can be characterised as an unfavourable group with respect to some factors relevant for compliance. Often they show unstable and/or narcissistic personalities, problems in establishing interpersonal relationships, a lack of insight into their disturbance, a low

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