Cross-sectional study of internalised stigma and medication adherence in patients with obsessive compulsive disorder

Abstract

BackgroundPatients suffering from psychiatric disorders tend to stigmatise themselves which had been linked to poor adherence to treatment.AimsThe aim of the present study was to study internalised stigma and medication adherence and to assess the relationship between them in patients with obsessive compulsive disorder (OCD).MethodsA cross-sectional study was conducted on 112 patients diagnosed with OCD who were attending the Out-patient's department at Department of Psychiatry of a tertiary care hospital in North India. Internalised stigma and current medication adherence were assessed with Internalized Stigma of Mental Illness Scale (ISMI) and Medication Adherence Rating Scale, respectively. Yale-Brown Obsessive Compulsive Scale was used to assess the current severity of OCD symptoms. Sociodemographic and clinical details were also obtained from the patients by using a semistructured sociodemographic proforma.ResultsMost of the patients reported moderate level of internalised stigma with a mean ISMI score of 77.98 (10.82). Most of the patients were compliant while 41.96% reported poor medication adherence. Internalised stigma was negatively correlated with the current medication adherence. Current severity of OCD symptoms also showed a significant positive correlation with internalised stigma and a significant negative correlation with medication adherence.ConclusionHigh levels of internalised stigma were associated with lower adherence to treatment which suggests that internalised stigma may be a very important factor influencing medication adherence in patients with OCD.

Prevalence of obsessive-compulsive disorder (OCD) among Iraqi undergraduate medical students in time of COVID-19 pandemic

“…Obsessive-compulsive disorder (OCD) is reported to be the fourth most frequent mental disorder worldwide [ 5 , 6 ]. OCD prevalence varies over age, regions, and others.…”

“…On the other hand, OCD can adversely affect academic performance, general well-being, social interaction, and suicidal thoughts. Issues that might have a huge impact on life unless being diagnosed early and properly managed [ 4 , 6 , 11 , 12 , 17 ].…”

Self-Stigma and Treatment Effectiveness in Patients with SSRI Non-Responsive Obsessive-Compulsive Disorder

“…The Shapiro–Wilk test assessed the normality of the data. Sample size estimation concerning the first set of hypotheses was based on data from the studies of Ansari et al ( N = 112, r = 0.61 for the connection between the self-stigma and obsessive-compulsive symptoms), 20 Ociskova et al ( N = 109, r = 0.31 for the self-stigma and overall severity of the mental disorder, r = 0.33 for the self-stigma and anxiety, r = 0.55 for the self-stigma and depressive symptoms, and r = 0.44 for the self-stigma and dissociation), 22 and Grambal et al ( N = 184, Cohen’s d = 0.52 for the self-stigma in patients with and without a personality disorder) 21 with Prasko et al ( N = 63, Cohen’s d = 0.60 for the same purpose). 19 The estimation of the second set of hypotheses was based on data from the studies of Prasko et al ( N = 63, r = 0.50 for the self-stigma and the relative change of overall severity of the mental disorder and r = 0.27 for the relative change of the depressive symptoms) 19 and Ociskova et al ( N = 109, r = 0.26 the self-stigma and the relative change of anxiety).…”

“… 17 , 18 The self-stigma has been related to more severe symptoms of anxiety, depression, and dissociation in patients with depressive and anxiety disorders 19 and more severe OCD symptoms. 20 Patients with a personality disorder 21 , 22 show higher tendencies towards self-stigmatization, though not all studies find such connection. 23 In a study by Deres et al 24 inpatients with higher self-stigma showed lower engagement and working alliance in psychotherapy.…”

“… 19 The self-stigma was identified as a predictor of lower medication adherence in patients with OCD. 20 …”