Prospective study of psychiatric follow-up default and medication compliance after discharge at a psychiatric hospital in Nigeria.

We report a prospective follow-up of 81 patients recently discharged from the hospital. Their hospital attendance pattern, medication compliance, mental state and social functioning were measured. Defaulters were followed up in the community. At 3 months, 49.4% had defaulted, while 51.5% were medication noncompliant. Clinical outcome was best for the Non-Defaulter-Medication Compliant (ND-MC) group, worst for the Defaulter-Medication Non-Compliant (D-MNC) group. Reasons for default include feeling well, financial difficulty, medication side effects and stigma. Medication non-compliant patients were more likely to reside more than 20 km away from hospital. There is an urgent need to provide community psychiatric services to improve patients' access to services and medication compliance.