Introduction: Non-compliance significantly influences the course and outcome of treatment. Non-compliance in Schizophrenia is common and a major challenge globally due to need of long duration of treatment and other related factors. The objective of study was to identify patients with treatment non-compliance and associated factors in schizophrenia from socio-cultural, familial and environmental perspective.Material and Method: This study identified non-compliance in schizophrenia among 80 patients attending outpatient department at department of psychiatry, Devdaha Medical College, Rupandehi, Nepal. The study was a descriptive cross section study and purposive sampling, a type of non-random sampling technique was utilized for study. Ethical consideration was done throughout the study and informed consent was taken prior to the study. The questionnaire was given to those patients who had insight into the illness and who were able to understand the questions in the pro forma. Informants of patients with poor insight were given questionnaire to complete.Results: Out of 80 participants, majorities (57.5%) were male and 42.5% were female in the ratio 1.35:1. The mean age of respondent was 30.2±11.6. Approximately one seventh (13.75%) of them were illiterate, more than half (61.25%) had family income less than Nepalese rupees 10,000 a month. A significant proportion (15%) of family members did not know the role of them and relatives, and majority (76.25%) said that people contribute negatively. The different factors contributing to non-compliance were belief as non treatable illness (20%), significant life events (2.5%), migration (3.75%), lack of access of treatment nearby (72.5%), forget doctor appointment (11.25%), cessation of medication as per advise of faith healer (10%), stop medicine due to social stigma (15%), not monitoring patient on medication (15%) and discontinuation of treatment on refusal (11.25%).Conclusion: The study explored noncompliance in Schizophrenia from socio-cultural, familial and environmental perspectives. Multiple factors were identified that contributed for non-compliance directly or indirectly. The non-compliance is a preventable condition that needs an emphasis from different perspectives.J Psychiatrists’ Association of Nepal Vol. 6, No. 2, 2017, Page: 22-27
Introduction: Dhat syndrome is generally believed to be a culture-bound which is characterized by excessive preoccupation with loss of "Dhat", which is generally taken to be representing semen. The study evaluated the symptoms of patient with Dhat syndrome visiting three mental health clinics of Rupandehi district.Material and Method This descriptive cross- sectional study was conducted in three different Psychiatry outpatient clinics at Rupandehi district of Nepal. Purposive sampling, a type of non-random sampling was utilized for the study. A total 50 patients with Dhat syndrome were enrolled in the study. A semi-structured Performa containing socio-demographic and Dhat syndrome symptoms related information was filled by respondents after providing written informed consent.Results: The patients were predominantly young adults, male with mean age of 23.1±4.6. Majority of them were in age group 18-25 years, hindu by religion, living in non-urban areas, family income of 5000-10000 per month, literate and unmarried. A range of psychological and somatic symptoms associated with Dhat syndrome were revealed. Most common symptoms found in the study were excessive worries (96%), tingling sensation of body (86%), weakness (80%), decrease interest (80%), fatigue (76%), depressed mood (74%), and generalized body ache (72%).Conclusion: Dhat syndrome presented with a range of psychological and somatic symptoms. Any male patient presenting with multiple somatic symptoms must be evaluated for Dhat syndrome and the physician must enquire about the semen loss and the associated beliefs.J Psychiatrists’ Association of Nepal Vol .6(1), 2017, p.33-37
Metabolic syndrome (MS), a constellation of interconnected metabolic disorders including obesity (central and abdominal), hyperglycemia, dyslipidemias and hypertension is highly prevalent among patients with schizophrenia. The prevalence of MS varies across countries and ethnic groups. There are multiple determinants of MS among patient with schizophrenia, important being age, sex, ethnic group, longer duration of illness, advanced age, and use of antipsychotics. Early detection and management of metabolic abnormalities could prevent associated premature morbidity and mortality in schizophrenia. Future research is needed to identify and explore genetic determinants of MS in schizophrenia which could help to prevent and manage the illness in better way.J Psychiatrists’ Association of Nepal Vol .6(1), 2017, p.3-11
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