Schizophrenia Attending Research Articles

Determinants of Disability Among Individuals Living with Schizophrenia Attending Psychiatric Follow-Up Clinic in Jimma, Southwest Ethiopia: An Institution-Based Case-Control Study.

Disability due to schizophrenia ends up with a higher degree of impairment in occupational, social and interpersonal functioning than other chronic illnesses. Despite severe and long-lasting schizophrenia associated disability, little has been explored so far to identify determinants of disability among individuals living with schizophrenia in Ethiopia. To identify the determinants of disability among individuals living with schizophrenia attending the psychiatric follow-up clinic at Jimma Medical Center (JMC). An institution-based unmatched case-control study was conducted among 98 Cases and 98 controls of individuals living with schizophrenia attending the JMC psychiatric clinic from September 1 to October 30, 2022. Consecutive sampling technique was used to recruit the required sample size of both groups. The cases group were participants who scored >12 total on the WHO Disability Assessment Scale version 2-0 (WHODAS 2-0) whereas the control group were those who scored 12 total on the WHODAS 2-0. Being jobless (AOR = 2.29; 95% CI: 1.10-4.77), longer than 5-year duration of illness without treatment (AOR = 3.13; 95% CI: 1.23-7.98), poor social support (AOR = 2.54; 95% CI: 1.04-6.22), negative symptoms (AOR = 2.45; 95% CI: 1.14-5.29), known family history of mental illness (AOR = 3.59; 95%: 1.67-7.73) and risky khat use (AOR = 4.37; 95% CI: 1.86-10.29) were found to be determinants of disability among schizophrenia patients. Joblessness, longer than 5-year duration of illness without treatment, poor social support, negative symptoms, known family history of mental illness and risky khat use were found to be determinants of disability in schizophrenia patients. Interventions targeting reducing of disability and improving quality of life of schizophrenia patients should consider the aforementioned determinants.

Attitudes toward COVID-19 pandemic measures and clinical symptom severity in schizophrenia patients: a preliminary cross-sectional study.

The study aim was to compare clinical symptom severity and quality of life (QoL) among schizophrenia patients according to their attitudes toward pandemic measures and reported lockdown-related disruption. Patients with schizophrenia attending follow-up sessions at two community mental health centers were included in this cross-sectional study. Sociodemographic and clinical characteristics of patients were assessed using a standardized form and the following psychometric instruments: the Positive and Negative Syndrome Scale, Brief Psychiatric Rating Scale, State-Trait Anxiety Inventory, Heinrich-Carpenter Quality of Life Scale and Clinical Global Impressions Ratings-Severity scale. Patients were grouped according to their attitudes toward pandemic measures (positive attitudes or non-positive attitudes). No significant differences were found in sociodemographic and clinical variables, clinical symptom severity or QoL between schizophrenia patients with positive attitudes and those without positive attitudes toward pandemic measures. Guilt feelings and trait anxiety levels were positively related to lockdown-related disruption. Positive attitudes toward pandemic measures may be affected by factors other than the sociodemographic and clinical status of schizophrenia patients. It is important that such factors are assessed in future studies to better manage pandemic-related challenges among schizophrenia patients.

Exploring perceived impact of caregiving and coping strategies adopted by family caregivers of people with schizophrenia: a qualitative study in Enugu, South East Nigeria

PurposeSchizophrenia, a chronic mental disorder, poses enormous threat to the individual, family and society. The advent of deinstitutionalization of the mentally ill transferred the burden of care to families especially close relatives. Few studies have described the families' subjective views in this context. Hence, this study aimed to explore impacts of caregiving and coping strategies for family caregivers of patients with schizophrenia in Enugu, South East Nigeria.Design/methodology/approachA descriptive qualitative design was employed, and 14 family caregivers of individuals with schizophrenia attending federal neuropsychiatric hospital Enugu were purposively selected. A semi-structured interview guide was used to generate information, and the transcribed data were content analyzed using a thematic approach.FindingsThree major themes and 16 subthemes were derived to reflect the perceived impact of caregiving and coping strategies of family caregivers, which include burden of care (physical-self neglect, ill health, sleep deprivation; psychological-gross irritability, ruminations; social-stigmatization, social restrictions, diminished connections, reduced productivity); positive aspects (heightened understanding; empathetic attitude, strengthened ties) and adaptive resources (acceptance, optimism, social support, spiritual devotion).Originality/valueFamily caregivers of individuals with schizophrenia experience bio-psychosocial burden as a result of caregiving. Coping with challenges of caregiving can prevent distress and burnout. Hence, there is need for mental health professionals to recognize caregivers as person in need of emotional and practical support and care for the mentally ill in the context of a family-centered approach.

Associations between health literacy, cognitive function and general literacy in people with schizophrenia attending community mental health clinics in Australia

BackgroundHealth literacy (HL) has been defined as the ability of individuals to access, understand, and utilise basic health information. HL is crucial to patient engagement in treatment through supporting patient autonomy, informed consent and collaborative care. In people with physical disorders, poor HL is associated with poor health outcomes, but less is known about HL in people with severe mental illness. This study aimed to assess HL and investigate the associations between education, cognitive function, general literacy, and HL in participants with schizophrenia attending community mental health clinics.MethodFifty-two outpatients with schizophrenia attending a public community mental health clinic in Adelaide, Australia completed the Test of Functional Health Literacy in Adults—Short Form (S-TOFHLA) along with tests of cognition, aural and reading literacy and numeracy including Digit Symbol Coding (DSC), verbal fluency, the Wechsler Adult Intelligence Scale (WAIS-IV), Woodcock-Johnson III (Part 4 and 9) and the Lipkus numeracy scale. Sixty-one percent of participants were male. Participants had a mean age of 41.2 (SD 9.9) years and a mean of 11.02 (SD 1.5) years of education.ResultsThe majority of participants had very poor aural and verbal literacy and poorer literacy correlated with fewer years of education. On the S-TOFHLA, 81% of participants had adequate HL; 6% were marginal and 13% were inadequate. There was a positive correlation between education and HL, with those with more years of education scoring higher for HL. There was also a significant association between better HL and better working memory and attention.ConclusionsConsistent with previous research in schizophrenia, our participants had reduced educational attainment, aural and reading literacy and cognitive function compared to population norms. However, HL was better than expected given that previous research has found that people with psychiatric disorders tend to have lower HL, compared to the general population. This may reflect effective case management of our participants whilst attending the community clinics and supports ongoing research and intervention regarding HL in people living with mental illness.

A qualitative exploration of perceived needs and barriers of individuals with schizophrenia, caregivers and clinicians in using mental health applications in Madhya Pradesh, India

IntroductionAbout 3.5 million people are living with schizophrenia in India, with most failing to receive minimally adequate care. Digital mental health applications could potentially decrease this treatment gap; however, these applications should be tailored to meet the needs and overcoming barriers of its end-users to ensure their adoption and sustained usage. Few studies in India have explored the perspectives of target stakeholders to understand how digital tools could be viable for supporting care. Therefore, this study explores the perceived needs and barriers of patients with schizophrenia, caregivers and clinicians in using digital mental health applications. MethodsFocus group discussions (FGDs) were conducted with patients having schizophrenia attending outpatient clinics at a government tertiary hospital, and their caregivers, and mental health clinicians in Bhopal, Madhya Pradesh, India. FGDs were audio-recorded and coded. Framework analysis was employed to guide the analysis, involving deductive and inductive generation of themes, data triangulation and comparison of perspectives between participant groups. ResultsSix FGDs were conducted with individuals with schizophrenia (n ​= ​11), their caregivers (n ​= ​14), and mental health clinicians (n ​= ​19). Four a priori themes were established: a) Prior experiences with health applications; b) Content of a mental health application; c) Involvement of caregivers in mental health application usage and d) Supporting doctors’ work through mental health applications. Additionally, two themes were generated inductively: a) Qualities of a mental health application and b) Data privacy and confidentiality. ConclusionExploration of stakeholder perspectives on the content, features, and uses of mental health applications is crucial to yield initial insights about the use of these digital programs in India. This study generated a multitude of suggestions on app functionality and components, which can guide ongoing efforts to develop and deliver digital mental health applications for patients living with schizophrenia in low-resource settings, with limited access to mental health services.

Relationship between the caregiver burden and the resilience among primary caregivers of individuals suffering from schizophrenia attending tertiary care rural hospital from central India: A cross-sectional observational study

Relationship between the caregiver burden and the resilience among primary caregivers of individuals suffering from schizophrenia attending tertiary care rural hospital from central India: A cross-sectional observational study

Antipsychotics Induced Movement and Sleep Disorder on Patients with Schizophrenia Attending Follow-Up Service

Antipsychotics Induced Movement and Sleep Disorder on Patients with Schizophrenia Attending Follow-Up Service

Alcohol use disorder and its determinant factors among patients with schizophrenia attending treatment at mental specialized hospital, Addis Ababa, Ethiopia: A cross-sectional study.

Background:Alcohol use disorder is one of the primary causes of avoidable death, illness, and injury in many societies throughout the world. Although alcohol use disorder can influence the natural history of a disease, disease recurrence, quality of life, and treatment adherence in psychiatric patients, the data on its magnitude is scarce.Objectives:This study was aimed to determine the magnitude of alcohol use disorder and its determinants among patients with schizophrenia attending a mental specialized hospital in Addis Ababa, Ethiopia.Methods:An institutional-based cross-sectional study was conducted from May 15 to June 15, 2018. An alcohol use disorder identification test was employed among a sample of 414 randomly selected patients with schizophrenia. Alcohol use disorder was categorized as hazardous drinking (Alcohol Use Disorders Identification Test (AUDIT) score of 8–15), harmful drinking (AUDIT score of 16–19), and alcohol dependence (AUDIT score of 20 or above). The data were entered into Epi-Data 3.1 and exported to SPSS 20 for analysis. Logistic regression was fitted to identify factors associated with alcohol use disorder.Results:The prevalence of alcohol use disorder was 38.4% (95% confidence interval (CI) 33.7, 42.9). Of this, 22.4% of the patients had hazardous drinking, 8.4% harmful drinking, and 7.6% alcohol dependence. Factors associated with alcohol use disorder were male sex (adjusted odds ratio (AOR) = 5.8, 95% CI 2.55, 13.19), being single (AOR = 3.0, 95% CI 1.63, 5.51), divorced (AOR = 4.3, 95% CI 1.95, 9.47) and widowed (AOR = 3.5, 95% CI 1.39, 8.81), having family history of alcoholism (AOR = 3.8, 95% CI 1.98, 7.19), longer duration of illness (AOR = 3.9, 95% CI 1.83, 8.36), previous history of psychiatric diagnosis (AOR = 2.2, 95% CI 1.1, 4.34), and concomitant use of non-alcoholic substances (AOR = 3.7, 95% CI 2.06, 6.74).Conclusions:Almost four in ten patients with schizophrenia had alcohol use disorder. Male sex, single, divorced, and widowed, family history of alcohol use, long duration of illness, previous history of psychiatric diagnosis, and concomitant use of non-alcoholic substances were significantly associated with alcohol use disorder. Continuous counseling of at risk populations about alcohol consumption should be strengthened.

A Cross-sectional Study of Antipsychotic Drugs Induced Sexual Dysfunction Among Married Males with Remitted Schizophrenia Attending Tertiary Health Care Centre from Central India

Introduction: Schizophrenia is a chronic debilitating disease having a major impact on the sufferers’ lives. Antipsychotic drugs are the mainstay of the treatment of schizophrenia. But, antipsychotics can lead to a variety of sexual dysfunctions among the males with schizophrenia, which may affect their treatment compliance. Aim: To assess the prevalence and the types of sexual dysfunctions among married males with remitted schizophrenia who were on a single oral antipsychotic drug from either class (i.e., typical or atypical type). Materials and Methods: The present cross-sectional study was conducted in a tertiary health-care centre from Central India, with a sample size of 100 married males with schizophrenia who were in the remission phase on a single oral antipsychotic drug. Data were collected by using a convenient sampling method. Socio-demographic profile and clinical variables were recorded in a specific case report form prepared for the study using the Arizona Sexual Experiences (ASEX) scale and the Udvalg for Kliniske Undersogelser (UKU) side-effect rating scale to assess the prevalence and the types of oral antipsychotic drugs induced sexual dysfunctions among study participants. Results: The prevalence of antipsychotic drug induced sexual dysfunction was 54%. The most common type of sexual side-effect of oral antipsychotic treatment was Decreased Sexual Desire/Drive (DSD) as assessed by both ASEX (94.4%) and UKU (63.0%) scales. Sexual dysfunctions like DSD and Ejaculatory Dysfunction (EJD) were associated with the treatment of schizophrenia with typical antipsychotic drugs. Conclusion: The present study shows that the treatment with typical antipsychotics was significantly associated with sexual side-effects. So, routine inquiry during the follow-ups should be done regarding the evaluation of sexual side-effects of antipsychotic agents in order to improve treatment compliance and disease prognosis.

Prevalence and Factors Associated with Depression among Primary Caregivers of Patients with Schizophrenia Attending Nigerian Tertiary Hospital

Prevalence and Factors Associated with Depression among Primary Caregivers of Patients with Schizophrenia Attending Nigerian Tertiary Hospital

Evaluation of nonadherence to treatment among patients with schizophrenia attending psychosocial care centers in the south region of Brazil.

Introduction The treatment of schizophrenia aims to reduce symptoms, improve quality of life and promote recovery from debilitating effects. Nonadherence to treatment is related to several factors and may lead to persistence of symptoms and relapse. Worldwide, the rate of nonadherence to treatment in individuals with schizophrenia is around 50%.Objectives To compare the clinical profile of nonadherent and adherent patients among individuals diagnosed with schizophrenia receiving treatment at psychosocial care centers in a city in southern Brazil.Method The clinical-epidemiological profile of patients with schizophrenia was retrospectively analyzed based on medical records entered into the system between January and December 2016, evaluating data at one-year follow-up.Results 112 patients were included. The disease was more prevalent in men; mean age was 40.5 years, being lower among men. Most of the sample had a low level of education, was unemployed/retired, did not have children and resided with relatives. The highest rate of diagnosis was among young adults. Psychotic symptoms were most frequently described, and the most commonly prescribed antipsychotic was haloperidol. The nonadherence rate was 15.2%; only one patient required admission to a psychiatric hospital. Among nonadherent patients, the mean time of attendance was 6 months; there were more nonadherent women than men. The most prevalent age range of nonadherence was 41-64 years. Psychosocial and clinical data were similar across the whole sample.Conclusion A nonadherence rate of 15.2% was found among individuals receiving treatment for schizophrenia, suggesting that psychosocial care centers were effective in treating and monitoring these patients.

Quality of Life and Associated Factors among Patients with Schizophrenia Attending Follow-Up Treatment at Jimma Medical Center, Southwest Ethiopia: A Cross-Sectional Study.

Background Schizophrenia is one of the most severe, chronic, and disabling mental disorders found globally. The chronic nature of the illness significantly interferes with functioning and results in a poor quality of life, but little is known about the quality of life among schizophrenia patients, in particular in low-income countries. Therefore, we assessed the quality of life and associated factors among patients with schizophrenia attending Jimma University Medical Center, Southwest Ethiopia. Methods The hospital-based cross-sectional study design was employed to collect data from 352 study participants using a systematic random sampling technique from June to July 2018. Patients' sociodemographic characteristic, quality of life, psychopathology, medication adherence, comorbid physical illness, and substance use disorder were assessed. Data entry and analysis were done using EpiData version 3.1 and Statistical Package for the Social Sciences (SPSS) version 21.0, respectively. Variables with a P value < 0.05 in the final multiple regression models were declared to be associated with the outcome variable. The Results. The response rate of the study was 99.7%. The mean (±standard deviation) score of the World Health Organization Quality of Life Assessment Short Version Scale was 74.34 ± 15.83. Positive symptoms, negative symptoms, general psychopathologies, comorbid physical illness, khat use disorder, tobacco use disorder, and medication nonadherence were negatively associated with patient quality of life. However, monthly income was found to be positively associated with quality of life. Conclusion and Recommendation. The mean and standard deviation of the quality of life of people with schizophrenia is found to be 74.34 ± 15.83 in this study. The social relationship domain was found with the lowest mean score. Therefore, priority interventions need to be implemented to improve the social deficits.

S56. SWITCHING FROM RISPERIDONE TO PALIPERIDONE PALMITATE IN SCHIZOPHRENIA: CHANGES IN COGNITIVE FUNCTION

BackgroundPrevious studies assessing the neurotoxicity of haloperidol, risperidone and paliperidone in cell culture suggest that paliperidone shows the strongest neuroprotective effect and a reduced apoptosis level. Other studies including patients with schizophrenia suggest that switching from risperidone long-acting injection (RLAI) to paliperidone palmitate (PP) may improve cognitive function in processing speed and attention. We aimed to study whether switching from risperidone to PP is associated with improved cognitive abilities at 3 or 6 months after the switch.MethodsOur initial sample included 32 patients with schizophrenia attending to the Department of Mental Health from Parc Taulí Hospital (Sabadell, Barcelona). All patients were treated with oral risperidone or RLAI (at least two months of stable treatment in monotherapy) and had the indication to be switched to PP by their psychiatrists. Of all 32 patients, 24 (75%) had at least a follow-up visit at 3 months. Therefore, statistical analyses were conducted in a final sample of 24 patients (88% men; 35.6 ± 12.3 years; 63% were receiving RLAI at baseline visit). Ethical approval was obtained from the local Ethics Committee and all participants provided written informed consent. Clinical diagnoses for schizophrenia were generated with the OPCRIT checklist v.4.0. Three assessments were completed: 1) baseline (pre-switch), 2) 3 months post-switch, 3) 6 months post-switch. Cognitive assessment was conducted at each visit with the MATRICS Consensus Cognitive Battery, which includes 10 cognitive tests for assessing 7 cognitive domains. Statistical analyses were performed with SPSS v 23.0 (IBM, USA). A non-parametric paired test (Wilcoxon test) was used for comparing changes in cognitive function over time (baseline vs 3 months; baseline vs 6 months). Significance was set at p<0.05.ResultsSignificant improvements in cognitive function were found for two cognitive tasks dealing with processing speed (BACS-SC and TMT-A) and one task dealing with attention and vigilance (CPT-IP) at both 3 and 6 months. Although reasoning and problem solving (NAB Mazes) or spatial working memory (WMS-III-Spatial Span) did not improve at 3 months, significant improvements in these two cognitive tasks were found at 6 months. Verbal memory, visual memory and social cognition did not improve over time.DiscussionIn patients with schizophrenia, switching from risperidone to PP is associated with cognitive improvement in tasks dealing with processing speed, attention, working memory and reasoning and problem solving. Our findings are in accordance with previous studies that suggest a potential neuroprotective effect of paliperidone. Some limitations of our study include the lack of randomization (no control group) and the small sample size. The small number of female patients does not allow to explore potential sex differences in the improved cognitive outcome.

Antipsychotic Use in Community Mental Health Service

Background: The use of antipsychotic medication remains an essential treatment modality for schizophrenia and related psychosis. However, there is a globally recognised variation in prescribing which is attributed to multiple factors. Guidelines set the expected standard and criteria for evidence based prescribing practice of antipsychotic medication. The aim of this clinical audit was to review antipsychotic prescribing patterns in adult patients with a history of schizophrenia or related psychosis attending community outpatients’ clinics and to verify the uniformity of this prescribing with clinical guideline recommendations. Methods: Information about the use of antipsychotic medication was collected in a sample of a 100 patients with a history of psychosis in Waikato region to investigate the consistency of antipsychotic medication prescribing practice using standard guidelines. Identifying inconsistent patterns of prescribing will offer opportunities for intervention and advancement of best and safe practice. Results: Most patients (86%) were maintained on a single antipsychotic medication within the recommended dose range. 27% of the patients were prescribed clozapine alone or in combination with other antipsychotic medication making clozapine the most frequently prescribed antipsychotic medication in our sample. Nearly half of the patients (48%) were on depot antipsychotic injections of which 20% were first-generation antipsychotic injections. Conclusions: Prescribing patterns of antipsychotics amongst our group of patients seem to be consistent with current evidence-based guidelines particularly with regards to class, frequency and dose range. Further research is required to assist in the formulation of Clozapine augmentation evidence-based guidelines.

Level of Perceived Social Support and Associated Factors Among People With Schizophrenia Attending Out Patient Department At Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia 2017

Background: Schizophrenia is a brain disorder which affects the way a person acts, thinks, and sees the world and causes difficulties in socializing with others creates a feeling of inability or inadequacy. Social support has an impact on mental and physical health throughout the life span. Lower social support has been associated with poor treatment outcomes. Poor social function has been found to increase admission rates.but in this study setting there is no evidence which shows the level of perceived social support and associated factors among people with schizophrenia. Objective: The aim of this study is to assess Level of perceived social support and associated factors among peoples with Schizophrenia at Amanuel mental specialized hospital, Addis Ababa, 2017. Method: An institutional based cross sectional study was conducted from May -to June -2017. Systematic random sampling technique was used to select study participants. Structured questionnaire with systematic random sampling approach followed by face to face interview technique were used. Epic-info version 7 and SPSS version 20 software were used for data entry and analysis respectively. Descriptive statistics were employed to describe the data. Data were fitted with bivariate and multivariate Ordinal logistic regression. Statistical significance were declared 95% confidence interval and P value <0.05. Results: A total of 410 study participants were participated. The study showed that; low perceived social support, medium perceived social support and high perceived social support account for 21.5%, 58.5% and 20% respectively. Poor medication adherence (AOR=3.61(95% CI; 2.10, 6.18), greater than 3 hospital admission (AOR=0.46(95% CI; 0.27, 0.79), primary (AOR=0.45(95%CI; 0.24, 0.82) and secondary level of education (AOR=0.53(95%CI; 0.31, 0.91) were found to be statistically significant associated with the outcome. Conclusion and Recommendation: This study showed that people with schizophrenia have lower and medium perceived social support. Health care providers should screen all schizophrenic patients for their medication adherence on a regular basis.

A study to assess the relationship between stigma and expressed emotion among the primary care givers of persons with schizophrenia attending outpatient department of Lokopriyo Gopinath Bordoloi Regional Institute of Mental Health, Tezpur

Background: Mental illness is a condition that impacts a person's thinking, feeling or mood and may affect his or her ability to relate to others and function on a daily basis. Among various types of mental illnesses schizophrenia is common disorder affecting approximately 1% of any given adult population. Stigma surrounding schizophrenia restraints the patient and family members to access the treatment facilities and type of support they need to manage their illness. It can also disturb the family environment which can often give rise to expressed emotion. Expressed emotion refers to a global index of particular emotions, attitudes and behaviours expressed by relatives of a family member diagnosed with schizophrenia. Aims and Objectives: The aim of the study was to assess the relationship between stigma and expressed emotion among the primary care givers of persons with schizophrenia. Materials and Methods: Descriptive co relational research design was used. The sample comprised of 60 primary caregivers of persons with schizophrenia attending OPD of LGBRIMH, Tezpur which was selected by using purposive sampling technique. Two standardized tool (Stigma subscale of Family Interview Schedule and Family Attitude Scale) and socio demographic data sheet was used for patient and primary care giver. Results: Finding showed majority of the sample i.e. 65% (n = 39) obtained the stigma score below 10.83 (mean score) and only 35% (n = 21) obtained the stigma score above10.83 (mean score).This finding showed that majority of the primary care givers has low stigma having a patient with psychiatric illness in their family. It was also showed that majority of the sample i.e. 66.7% have obtained expressed emotion score below 29.68 (mean score) and 33.3% have obtained expressed emotion score above 29.68 (mean score).This finding showed that the majority of the primary care givers has low expressed emotion towards a family member having schizophrenia. There was significant positive correlation found between stigma and expressed emotion among the primary care givers of persons with schizophrenia (calculated value was found to be 0.587 which was higher than the tabulated value at 0.01 level of significance). Conclusion: It showed that if stigma increases, the expressed emotion among the primary care givers towards the patient also increases.

Magico-religious Beliefs in Schizophrenia: A study from Eastern part of Nepal

Background &amp; Objectives: Schizophrenia is one of the commonest psychiatric disorders which require immediate interventions. Magico-Religious beliefs may affect the expression of psychopathology as beliefs are entrenched into human psyche. Local and community beliefs in such phenomena appeared to be a factor in influencing the decision to seek magico-religious treatment. This study aimed (1) to determine attitude of patients and relatives with respect to magico-religious beliefs and its influence on psychopathology, and (2) to examine the relationship between psychopathology and major sociodemographic variables.Materials &amp; Methods: All 50 consecutive cases of schizophrenia attending psychiatric services during study period were thoroughly evaluated. All the cases were diagnosed as per ICD 10 DCR criteria. The supernatural attitude questionnaire was applied.Results: Fifty cases were studied. Among them, 48% belonged to the age-group of 25 to 34 years, the majority of them were male (62%), 82% were Hindus, and 64% married. Majority of the patients had undergone magico-religious treatment (n = 35). Among the sample, 68% consulted faith healer and 42% performed religious treatment during the illness period; 60% acknowledged personal belief in sorcery, 58% in ghosts, and 52% in spirit intrusion. Among them, 20% believed there was a link between sorcery and mental illness, and 20% believe spirit could cause mental illness. Among the samples, 38% found the link between sorcery and abnormal behaviour, 38% with evil spirit, and 22% due to planetary influences. Statistically significant association was noted in the belief that rituals can improve patient behaviour and local belief in supernatural influences.Conclusion: There is a common belief in the relationship between supernatural influences and mental illness among the relatives of the patients. Such beliefs and magicoreligious treatment do occur during the course of the illness.

Prevalence of Antipsychotic Drug Non Adherence and Associated Factors Among Patients with Schizophrenia Attending at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia: Institutional Based Cross Sectional Study

Background: Drug non adherence is a problem in all areas of medicine, and psychiatry is no exception. Mental health institutions are widely over burdened by mental ill patient who sought frequent treatment as a result of drug non adherence. Although patients suffering from psychiatric disorders are the most likely not to adhere to treatment than any other physical illness; there was no study done to determine the prevalence and associated factors of antipsychotic drug non adherence among schizophrenia patients in Ethiopia. So this study was aimed to assess the prevalence and associated factors of antipsychotic drug non-adherence among patients with schizophrenia attending at Amanuel mental specialized hospital. Methods: An institution based cross-sectional study was conducted on 403 schizophrenia patients attending outpatient department of AMSH from March 26 to April 6, 2013. Morisky Medication Rating Scale and Drug Inventory Attitude were used to collect data. Three trained data collectors and one supervisor were involved in the data collection process. Ethical clearance was obtained from institutional review board of University of Gondar and Amanuel mental specialized hospital. Written informed consent was obtained from the respondents. Result: The study had response rate of 95.3%. A total of 268(66.5%) male were participated in this study. The mean age of participants was 32.7(SD+9.59 years) and age ranged from 18 to 57. Prevalence of antipsychotic drug non adherence was found to be 48.4%. The factors having co-morbid mental illness AOR=2.23, 95%CI (1.12, 4.45), Extra pyramidal side effect AOR=2.66, 95%CI (1.44, 4.91), Poly therapy AOR=2.37, 95%CI (1.21, 4.65), Negative attitude towards treatment AOR=3.79, 95%CI (1.56, 9.23) and alcohol use AOR=4.72, 95%CI (1.79, 12.46) were found to be significantly associated with antipsychotic drug non adherence. Conclusion: About half of patients were found to be nonadherent. The factors substance use, extra pyramidal side effects, co-morbid depression, attitude towards treatment and lack family encouragement were found to be significantly associated with drug non adherence. At last self-reported method used in this study tends to under estimate non adherence conducting further study by combining certain methods is of paramount importance.

Perceived Empowerment and Quality of Life of Persons with Schizophrenia Attending Community based Psychosocial Rehabilitation

Perceived Empowerment and Quality of Life of Persons with Schizophrenia Attending Community based Psychosocial Rehabilitation

Prevalence of Antipsychotic Polypharmacy and Associated Factors among Outpatients with Schizophrenia Attending Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia

Background. Despite recommendations by guidelines to avoid combinations of antipsychotics unless after multiple trials of antipsychotic monotherapy, it is quite a common practice to use combinations. This practice leads to unnecessary expenses and exposes the patient to severe drug adverse effects. Methods. An institution based cross-sectional study was conducted from April to May 2014. Systematic random sampling technique was used to select 423 study subjects. Logistic regression analysis was conducted to identify associated factors of antipsychotic polypharmacy among schizophrenia outpatients. Result. The overall prevalence of antipsychotic polypharmacy was found to be 28.2%. Extra pyramidal side effects (AOR = 2.80; 95% CI: 1.38, 5.71), repeated psychiatric hospitalization (AOR = 2.83; 95% CI: 1.45, 5.50), history of substance use (AOR = 2.82; 95% CI: 1.36, 5.88), longer duration of treatment (AOR = 2.10; 95% CI: 1.14, 3.87), and drug nonadherence (AOR = 1.84; 95% CI: 1.14, 2.98) were found to be significantly associated with antipsychotic polypharmacy. Conclusion. Prevalence of antipsychotic polypharmacy was found to be high among the current study participants. Individuals who had extra pyramidal side effects, admission, substance use, duration of treatment, and drug nonadherence were associated with antipsychotic polypharmacy.