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COMPLIANCE AND CONFLICT IN ADOLESCENCE

Some years ago, a survey was carried out in Israel with regard to adults with hypertension requiring long-term medication. It was found that many of them tended to diminish the amount of medication and even to cease taking medicines, when they felt better under the assumption that taking too much medicine "might not be good for one's body". If this be the case with many serious-minded middle-aged adults quite concerned about the welfare of their bodies, what can be expected from adolescents with regard to compliance to a medical regime on a long term basis? In the Oxford English Dictionary, compliance is defined as "yielding". To comply is to act in accordance with such as complying with a request or a command. Conflict is defined as a "trial or strength between opposed parties or principles". When a physician such as a neurologist, prescribes long-term medication for a young person with epilepsy, the question that arises is: "Is this a request or a command?" With regard to a child, a doctor expects the parents to be responsible for the medical regime. With a mature adult, the doctor relies on the understanding and sense of responsibility of the patient. But the adolescent patient, being neither an obedient child nor a responsible adult, is in a much more ambiguous and tricky situation with regard to compliance in general, and compliance to a medical regime or a health behaviour pattern in particular. For instance, compliance in an adolescent with epilepsy is a real problem. Consciously or unconsciously, the adolescent believes that if he or she is taking medicine it is a sign of sickness and conversely not taking medicine is a sign of health. It is not surprising therefore that compliance in adolescents with epilepsy is low, and this is a cause for concern. I believe