A study of compliance and insight in patients with schizophrenia

Abstract

Schizophrenia is a major psychiatric disorder with prevalence of 1%. The long course of illness warrants strict compliance to antipsychotic medications which is a common challenge faced by the treating psychiatrist and it affects the quality of life of the patient and the caregiver. This study aims to understand the complex relationship between insight of having the illness and compliance to medications. To study the relationship between insight and medication compliance in schizophrenia.This cross-sectional study included 50 patients diagnosed with schizophrenia, attending the psychiatry OPD or admitted in psychiatry ward who fulfilled the inclusion criteria. After taking the informed consent, the compliance and patients’ attitude towards illness and medication was assessed using Adherence to medication regimen. Insight was assessed using Scale to Assess Unawareness of Mental Disorder.A total of 21 patients (42%) were fully compliant to their treatment, whereas more than half of patients had full insight into their illness (n=30, 60%). Lack of insight correlated with poor compliance. Patients with poor compliance were also less aware of the beneficial effects of the treatment. There was also a statistically significant relationship between insight, compliance and patients’ belief that medications help in keeping them in good mental health.Patients with better understanding of nature of illness and symptoms were more compliant with medications. This reinforces the role of insight facilitation along with psychoeducation of family members regarding compliance in the treatment of schizophrenia. Further exploration of patients’ and relatives' concept of illness and the treatment are needed to develop interventions to improve compliance.