Background:Compliance or noncompliance with treatment significantly influences course and outcome of psychiatric disorders. While noncompliance has been extensively researched, compliance has received less attention. The current study was conducted to elicit reasons for compliance and noncompliance in patients having psychoses attending psychiatric clinics.Materials and Methods:A total of 196 compliant and 150 noncompliant patients were interviewed using self-designed tools to elicit sociodemographic data, details of illness, and treatment. Factors contributing to compliance and noncompliance were grouped under illness-related, clinician-related, medication-related, family-related, and economic-related domains and compared.Results:Compliance was significantly more in females and middle- and high-socioeconomic status patients. They had less substance use, high physical comorbidity, high attendance in the outpatient department, and better remission. Clinician-related, family-related, and medication-related domains were contributing more to compliance whereas illness-related and economic-related domains seemed to have more bearing on noncompliance.Conclusions:Compliance and noncompliance are determined multidimensionally. Domains related to clinician, family, and medications have to be reinforced to enhance compliance. Illness-related and economic domains have to be resolved to reduce noncompliance.
Aim: To study the clinical presentations and gender differences of conversion disorder in children less than 16 year old and correlate it with socio-demographic characteristics and stress factors. Methods: All case records of children presenting to psychiatry unit of a general hospital during last 5 years (both outpatient and inpatient) and having a diagnosis of ICD-10 Dissociative (conversion) disorders, were reviewed. Results: A total of 12 % ( n=512) had a diagnosis of conversion disorder, both genders having equal representation. Dissociative motor disorder was more common among males and dissociative convulsions among females. Academic and strained interpersonal relationships were the most common stress factors. Majority had la belle indifference and secondary gain and received outpatient treatment, and had complete recovery at last follow up. Conclusions: Conversion disorders are one of the most common diagnosis. Significant gender differences in mode of presentation and nature of stress are present. However the response to treatment is prompt and chance of recovery is high in both genders. Relevance: This study was done in a developing country where conversion disorder is seen commonly.
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