Dr Rinku Gautam Joshi is an Associate Professor of Psychiatry in BP Koirala Institute of Health Sciences, Dharan, Nepal. Her interest is in Women’s Mental Health.
Statement of the Problem Non-compliance to treatment is an important area of concern in mental illness as it contributes to relapse and hospitalization of patients. One of the ways to improve drug compliance is to know the crucial factors responsible for poor drug compliance so that proper management strategies may be planned to improve patients’ compliance. Methodology & Theoretical Orientation Aims: To find out the prevalence and reasons of non-compliance in patients with schizophrenia and its association with socio-demographic variables. Methodology: Patients attending psychiatric services, who are diagnosed as Schizophrenia as per ICD-10/DCR were enrolled and socio-demographic details obtained. Patients were evaluated using the PANSS to assess severity of illness. Subjective reasons of medication non-compliance were assessed using ROMI scale.The relation between non-compliance and socio-demographic profile was analyzed and reasons for non-compliance were studied. Findings: In the study the mean age of patients was 30.78±12.53 yrs (mean ± SD). It was observed that 46.3% were compliant and 53.8% were non-compliant. A significant association was found between duration of illness and mean negative score. The main reason for non-compliance identified in the present study was denial of illness followed by no current need for medications which may be due to the lack of knowledge about the illness. Conclusion & Significance: More than half of the patients were non-compliant. The main reason for non-compliance was denial of illness and considering no current need for medications which may be because of lack of knowledge about the illness that signifies the importance of psychoeducation. Recommendations are made for starting support groups to tackle the problems of the family members in managing the patient effectively; and developing standard protocol for providing consistent medication adherence counseling for the mental health professionals, which will improve the compliance to medication and treatment.
Yizhen Yu is a Professor in School of Public Health, Tongji Medical College, Huazhong University of Science
Objectives: Accumulating evidence suggests that genetic and environmental factors may influence aggression susceptibility. Compared to some extensively studied candidate genes of aggression, very little is known about the OXTR gene. The objective of this study was to determine whether genetic variants in the OXTR gene were associated with aggression risk and whether the polymorphisms would show interactive effects with childhood maltreatment on aggressive behavior in Chinese adolescents. Methods: A total of 996 participants including 488 cases and 488 controls were selected in our study. Aggression, childhood maltreatment were measured by self-reported questionnaire. Buccal cells of all subjects were collected. Genotyping was performed using SNPscan. We explored both main effects of OXTR polymorphisms, as well as interactive effects between the polymorphisms and childhood maltreatment on aggressive behavior. Results: Participants who carried the rs237885 TT genotypes in OXTR gene had a higher risk of aggression compared to those who carried GG or GT genotypes under the recessive model (OR=1.40, 95% CI, 1.04–1.89) after controlling for potential confounders. In addition, we also found that the polymorphism had a synergic additive interaction with childhood physical abuse on the aggression risk. The synergy index (S), the attributable proportion due to interaction (AP) and the relative excess risk due to interaction (RERI) were 2.81 (95% CI, 1.37–5.77), 0.59 (95% CI, 0.33–0.84) and 6.69 (95% CI, 0.41–12.96), respectively. Conclusions: The present study provides evidence that genetic variants of OXTR may contribute to the susceptibility of aggression. Moreover, this is the first study reporting significant interactive effects of OXTR polymorphism and childhood physical abuse on aggressive behavior in Chinese adolescents.