Evaluation of therapeutic compliance in psychiatry

Abstract

IntroductionTherapeutic non-adherence is a problem frequently encountered in patients suffering from psychotic disorders. It has consequences on the quality of life and on the prognosis of the evolution of the disease. It is essential to understand the causes in order to best support the patient towards adherence to care.ObjectivesThe objective of the study is to evaluate the therapeutic observance of patients hospitalized in the women’s department of the psychiatric hospital and to collect the reasons for therapeutic non-observance, as well as to identify the desired themes for the implementation group therapeutic education workshops.MethodsIt is a monocentric and prospective study, carried out in the women’s department through individual interviews on day 7 +/- 2 of the admission of patients to the psychiatric hospital of Tangier. The inclusion criteria are:-the patient’s consent,-the autonomous taking of a treatment before admission,-sufficient communication skillsThe psychometric tool used during this study is the MARS scale (Medication Adherence Report Scale) which allows the patient to assess his compliance, by answering 10 questions, assigning himself a score between 0 and 10 with a good compliance from 8/10. The discussion following the questionnaire makes it possible to identify the reason(s) for non-compliance and the themes to be addressed to improve compliance.ResultsOur first initial results were calculated from 60 patients admitted to hospital. Among them, 35 met the criteria for inclusion in the study. The interview takes place within an average of 8.0 ± 2.3 days. The average age is 40 ± 15 years. Patients present with schizophrenia in 80% of cases, bipolarity (8%) or borderline personality disorder (3%). Nine percent of patients have no diagnosis. Patients take an average of 2.5 drugs [1; 5] before hospitalization. The average MARS score is 5.6 ± 2.6. The reasons for non-adherence identified by patients are:-The presence of side effects,-Lack of means-Feeling of healing-The weariness of a long treatment-Inefficiency,-fear of interactions in case of toxic consumption-five patients declared observing and did not identify any reason for non-complianceConclusionsOur study has made it possible to better understand the difficulties and support needs of patients to improve their adherence to care. As a follow-up to this work, a multidisciplinary discussion will allow the setting up of group therapeutic education workshops around the identified themes.Disclosure of InterestNone Declared

Marital Rape as Structual Violence in the Legal System

“…This not only results in immediate physical harm but also contributes to enduring psychological distress for the victim. Martin delineates three distinct patterns of this aggression [4]:…”

“…Women are disproportionately subjected to a range of violent acts by family members throughout their lives, including both physical and psychological harm. The disturbing prevalence of such violence is compounded by systemic disparities that restrict women's access to essential services like healthcare, education, and avenues for political advocacy, particularly when they are confronting violence perpetrated by men and trying to exercise their basic human rights [4]. The health repercussions of marital rape are profound and varied, encompassing conditions such as fistulas, various disabilities, HIV/AIDS, unintended pregnancies, and the tragic outcomes of abortions and stillbirths.…”

“…Despite the recognition of these issues as a grave public health matter, prevailing patriarchal structures often pose formidable barriers to women seeking the necessary medical attention and support services. Their reluctance to seek help can be attributed to numerous factors, including the fear of reprisal, a sense of powerlessness, shame, self-blame, and the pervasive minimization of marital rape's severity [4]. These factors not only shape the victims' decisions to seek assistance but also influence the sources from which they might seek such help.When women do reach out for legal support, they frequently encounter judgment or blame for the violence inflicted upon them, even when there is evident victimhood.…”