Narayanan Dinesh, Jith Arya, Bansal Rahul
Department of Psychiatry, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
Indian J Psychiatry. 2020 May-Jun;62(3):290-294. doi: 10.4103/psychiatry.IndianJPsychiatry_357_19. Epub 2020 May 15.
Bipolar disorder is a disabling psychiatric disorder. The existing literature suggests about 41% of patients to be nonadherent. Nonadherence leads to relapses, delay in recovery besides higher inpatient care cost as well as higher global cost of the disease. Nonadherence in bipolar affective disorder (BPAD) is a complex phenomenon, its critical determinants are yet to be identified with certainty.
This study aims to assess the prevalence of nonadherence in BPAD and to delineate the factors associated with it.
Medical records were reviewed in this study from 2005 to 2019 at a medical college in Kerala. Patients who were diagnosed with BPAD according to International Classification of Diseases 10 and who were needing or opting for prophylaxis were included. Patients who were not taking medications for at least 1 week were termed as nonadherent. We included 150 participants in our study.
To test the statistical significance of the association of categorical variables between H/O of adherence and nonadherence, Chi-square test was used. In the sample, 82.7% had at least 1 week of history of noncompliance in the past. The most common reason was poor understanding of illness by the family (56%) followed by a negative aspect of the patient toward the drug (20%).
Therefore, this study concludes that though majority of the patients have a history of nonadherence of at least 1 week on long-term follow-up, it was seen that majority of the patients were more than 80% adherent to medications.
双相情感障碍是一种致残性精神疾病。现有文献表明，约41%的患者不依从治疗。不依从会导致病情复发、康复延迟，此外住院护理成本更高，疾病的总体成本也更高。双相情感障碍（BPAD）中的不依从是一个复杂的现象，其关键决定因素尚未确定。
本研究旨在评估BPAD中不依从的患病率，并确定与之相关的因素。
本研究回顾了喀拉拉邦一所医学院2005年至2019年的病历。纳入根据国际疾病分类第10版诊断为BPAD且需要或选择进行预防的患者。未服药至少1周的患者被视为不依从。我们的研究纳入了150名参与者。
为检验依从性和不依从性病史之间分类变量关联的统计学意义，采用了卡方检验。在样本中，82.7%的患者过去至少有1周的不依从病史。最常见的原因是家属对疾病的了解不足（56%），其次是患者对药物的负面态度（20%）。
因此，本研究得出结论，尽管大多数患者在长期随访中有至少1周的不依从病史，但可以看到大多数患者对药物的依从性超过80%。
