Drug treatment is only a part of what the patient needs

Worldwide 40 antipsychotic preparations are available and twice as many antidepressants. As a patient with a recurrent depressive disorder myself it would be comforting to think that choice of treatment is based on a concordance between the patient's wishes and the doctor's advice. In reality it will reflect the many factors that affect their relationship—medical attitudes; the way information is presented; the capacity of patients to understand this information and to relate it to their condition; health service, social, and commercial pressures. Not surprisingly, Cochrane reviews of interventions to improve “adherence” show findings that are inconsistent or complex.1 2 Adherence can only be improved by mutual respect.