Adherence, Self-stigma and Discontinuation of Pharmacotherapy in Patients with Anxiety Disorders: Cross-sectional Study

Abstract

Treatment adherence is one of the main factors affecting the success of treatment, quality of life and social adaptation of the patients. The cross sectional study was conducted on 120 neurotic outpatients treated in University hospital Olomouc, Czech Republic. The aim of the study was to investigate association between self-stigmatization, treatment adherence and history of discontinuation of drug treatment. The following variables were evaluated: were objective and subjective CGI (Clinical Global Impression – Severity), the adherence questionnaire DAI-10 (Drug Attitude Inventory), the self-stigma scale ISMI (Internalized Stigma of Mental Illness), and the demographic data questionnaire. 98 patients completed all the questionnaires, 22 patients completed questionnaires inadequately and or did not cooperate sufficiently. Data analysis showed no correlation between self-stigmatization and age, age of onset or length of post-hospitalization phase. However, there was a statistically significant correlation between self-stigmatization and the severity of psychopathology, the arbitrary discontinuation of medication in the past and the dose of an antidepressant. Furthermore, self-stigma significantly negatively correlated with the current treatment adherence. The level of adherence negatively correlated only with the subjective and objective CGI. Our results suggest strong association between self-stigmatization and adherence to treatment in neurotic patients. We may conclude that more attention should be paid to manage self-stigmatization in this patient group.