ABSTRACTS - World Psychiatric Association
ABSTRACTS - World Psychiatric Association
ABSTRACTS - World Psychiatric Association
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gradually distanced the community and even the relatives from care<br />
of patients. The establishment of a directorate of community mental<br />
health services in 2006 by the hospital management resulted in the<br />
articulation of a community mental health programme for the hospital.<br />
The programme, which includes intensive media (television) as<br />
well as face-to-face mental health education and information campaigns,<br />
from July 2007 is at an early phase of implementation. There<br />
is active education of existing service users and relatives on the benefits<br />
of use of services close to their place of residence. We found<br />
increased service utilisation related to increased mental health awareness<br />
and a trend towards appropriate service utilisation following<br />
commencement of community programme. Mental health professionals<br />
need to shift from mental hospital based practice to service provision<br />
in the community and for the existing federal neuropsychiatric<br />
hospitals to make definite commitments towards development of<br />
community mental health services in their zones.<br />
ZS6.3.<br />
MEDICATION ADHERENCE IN NIGERIAN<br />
PSYCHIATRIC OUTPATIENT CLINICS<br />
A. Adewuya<br />
Department of Psychiatry, Lagos State University Teaching<br />
Hospital, Ikeja, Lagos, Nigeria<br />
The aims of this study were to assess the rate of adherence to medications<br />
amongst psychiatric outpatients in Nigeria and examine factors<br />
associated with medication non-adherence amongst this group. <strong>Psychiatric</strong><br />
outpatients (n=342) from three centres were assessed for<br />
medication adherence using the Morisky Medication Adherence<br />
Questionnaire. Details regarding sociodemographic variables (age,<br />
sex, education, religion, marital status, employment, income, medication<br />
cost), illness related variables (diagnosis, duration, number of<br />
episodes/admissions, insight, severity of symptoms, mental state,<br />
functional status), medication related variables (type, mode of administration,<br />
side effects, attitudes to medication) and perception related<br />
variables (self-stigma, perceived causation and prognosis) were also<br />
obtained. There were 76 (22.2%) participants with good medication<br />
adherence, 102 (29.8%) with moderate adherence and 164 (48.0%)<br />
with poor adherence. The significant independent correlates of poor<br />
medication adherence included being employed (OR 3.42; 95% CI<br />
2.17-5.39), poor social support (OR 5.86; 95% CI 2.87-12.17), high<br />
self-stigma (OR 4.70; 95% CI 2.24-9.96) and perceived spiritual causation<br />
of mental illness (OR 3.74; 95% CI 1.87-7.74). The majority of<br />
psychiatric outpatients in south-western Nigeria had poor medication<br />
adherence. Our findings stress the importance of patients’ perception<br />
and social environment in determining treatment adherence and the<br />
necessity of educating the patient. Clinicians’ attention to psychological<br />
barriers early in treatment may improve medication adherence<br />
and ultimately affect the course of illness.<br />
ZS6.4.<br />
IMPACT OF ATYPICAL AND CONVENTIONAL<br />
ANTIPSYCHOTICS ON THE QUALITY OF LIFE<br />
OF PATIENTS WITH SCHIZOPHRENIA:<br />
A PRELIMINARY REPORT FROM LAGOS<br />
TEACHING HOSPITALS<br />
A. Erinfolami, B. Ola, A. Olagunju<br />
Department of Psychiatry, University of Lagos; Department of<br />
Psychiatry, Lagos State College of Medicine, Ikeja, Lagos, Nigeria<br />
In sub-Saharan Africa, the use of atypical antipsychotics is still limited,<br />
because of their prices and availability. Studies addressing the<br />
impact of different antipsychotic therapies on the subjective quality of<br />
life of African schizophrenic patients are few. This study seeks to<br />
compare the subjective quality of life of schizophrenic patients treated<br />
with either conventional or atypical antipsychotics. One hundred<br />
patients meeting ICD-10 criteria for the diagnosis of schizophrenia<br />
were included in this two-centre study. In each centre, 20 schizophrenic<br />
patients were treated with haloperidol, 15 with risperidone<br />
and 15 with olanzapine for a 6-week period. The symptomatology of<br />
the patients was assessed using the Positive and Negative Syndrome<br />
Scale (PANSS); quality of life was assessed by the WHOQoL-BREF.<br />
The atypical antipsychotic group had significantly higher scores in<br />
general quality of life as well as in different life domains: physical<br />
health, environment, psychological and social relationship in everyday<br />
life. In the individual comparisons of the atypical and conventional<br />
antipsychotics, patients on olanzapine or risperidone had higher<br />
quality of life scores than patients on haloperidol.<br />
ZS7.<br />
MOOD DISORDERS IN IRAN: AN UPDATE<br />
(organized by the WPA Central and Western Asia<br />
Zone)<br />
ZS7.1.<br />
A BIBLIOMETRIC ANALYSIS OF RESEARCH<br />
ON MOOD DISORDERS IN IRAN<br />
M. Amin Esmaeili, S.S. Gudarzi, N. Mahdavi<br />
Mood Disorder Section, Iranian <strong>Psychiatric</strong> <strong>Association</strong><br />
The studies on the burden of disease in Iran revealed that psychiatric<br />
disorders ranked the second among all medical illnesses. Depressive<br />
disorders were shown to be the most disabling disease among<br />
women. To define a prospective view of the studies on mood disorders<br />
in Iran, we performed a bibliometric study on the relevant literature.<br />
All the papers from Iran which were published in the national<br />
and international scientific journals were assessed. Two Iranian databases,<br />
Iranmedex and Iranpsych, and two International databases,<br />
Medline and Embase, were searched. All the articles were assessed by<br />
three psychiatrists with good inter-rater reliability. In total, 973 articles<br />
achieved the inclusion criteria. The subject of articles was depressive<br />
disorder (78.4%), bipolar disorder (7.8%) and suicide (10.2%).<br />
An increasing trend in publications on mood disorders in Iran was<br />
found. Most of the studies have targeted depressive disorders. The<br />
most substantial increase was found in epidemiological studies (representing<br />
53.8% of the total). The methodology of the studies was<br />
descriptive in 32.8% of cases, descriptive/analytic in 39.5% and analytic<br />
in 28%. An increase in published research on bipolar disorders<br />
has only started since 2000. The rate of publications in international<br />
journals has shown a sharp increase since 2000. Nevertheless, considering<br />
the prevalence of mood disorders in Iran, the whole scientific<br />
output remains insufficient.<br />
ZS7.2.<br />
DEPRESSION IN THE IRANIAN CULTURAL<br />
CONTEXT<br />
H. Davidian<br />
University of Tehran, Iran<br />
The prevalence of depressive disorders in the general population in<br />
Iran is about 10%. About 10% of the patients seen by general practitioners<br />
suffer from depression, 50% of whom remain undiagnosed. 30-<br />
60% of the patients admitted to general hospitals for physical illnesses<br />
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