ABSTRACTS - World Psychiatric Association

gradually distanced the community and even the relatives from care
of patients. The establishment of a directorate of community mental
health services in 2006 by the hospital management resulted in the
articulation of a community mental health programme for the hospital.
The programme, which includes intensive media (television) as
well as face-to-face mental health education and information campaigns,
from July 2007 is at an early phase of implementation. There
is active education of existing service users and relatives on the benefits
of use of services close to their place of residence. We found
increased service utilisation related to increased mental health awareness
and a trend towards appropriate service utilisation following
commencement of community programme. Mental health professionals
need to shift from mental hospital based practice to service provision
in the community and for the existing federal neuropsychiatric
hospitals to make definite commitments towards development of
community mental health services in their zones.
ZS6.3.
MEDICATION ADHERENCE IN NIGERIAN
PSYCHIATRIC OUTPATIENT CLINICS
A. Adewuya
Department of Psychiatry, Lagos State University Teaching
Hospital, Ikeja, Lagos, Nigeria
The aims of this study were to assess the rate of adherence to medications
amongst psychiatric outpatients in Nigeria and examine factors
associated with medication non-adherence amongst this group. Psychiatric
outpatients (n=342) from three centres were assessed for
medication adherence using the Morisky Medication Adherence
Questionnaire. Details regarding sociodemographic variables (age,
sex, education, religion, marital status, employment, income, medication
cost), illness related variables (diagnosis, duration, number of
episodes/admissions, insight, severity of symptoms, mental state,
functional status), medication related variables (type, mode of administration,
side effects, attitudes to medication) and perception related
variables (self-stigma, perceived causation and prognosis) were also
obtained. There were 76 (22.2%) participants with good medication
adherence, 102 (29.8%) with moderate adherence and 164 (48.0%)
with poor adherence. The significant independent correlates of poor
medication adherence included being employed (OR 3.42; 95% CI
2.17-5.39), poor social support (OR 5.86; 95% CI 2.87-12.17), high
self-stigma (OR 4.70; 95% CI 2.24-9.96) and perceived spiritual causation
of mental illness (OR 3.74; 95% CI 1.87-7.74). The majority of
psychiatric outpatients in south-western Nigeria had poor medication
adherence. Our findings stress the importance of patients’ perception
and social environment in determining treatment adherence and the
necessity of educating the patient. Clinicians’ attention to psychological
barriers early in treatment may improve medication adherence
and ultimately affect the course of illness.
ZS6.4.
IMPACT OF ATYPICAL AND CONVENTIONAL
ANTIPSYCHOTICS ON THE QUALITY OF LIFE
OF PATIENTS WITH SCHIZOPHRENIA:
A PRELIMINARY REPORT FROM LAGOS
TEACHING HOSPITALS
A. Erinfolami, B. Ola, A. Olagunju
Department of Psychiatry, University of Lagos; Department of
Psychiatry, Lagos State College of Medicine, Ikeja, Lagos, Nigeria
In sub-Saharan Africa, the use of atypical antipsychotics is still limited,
because of their prices and availability. Studies addressing the
impact of different antipsychotic therapies on the subjective quality of
life of African schizophrenic patients are few. This study seeks to
compare the subjective quality of life of schizophrenic patients treated
with either conventional or atypical antipsychotics. One hundred
patients meeting ICD-10 criteria for the diagnosis of schizophrenia
were included in this two-centre study. In each centre, 20 schizophrenic
patients were treated with haloperidol, 15 with risperidone
and 15 with olanzapine for a 6-week period. The symptomatology of
the patients was assessed using the Positive and Negative Syndrome
Scale (PANSS); quality of life was assessed by the WHOQoL-BREF.
The atypical antipsychotic group had significantly higher scores in
general quality of life as well as in different life domains: physical
health, environment, psychological and social relationship in everyday
life. In the individual comparisons of the atypical and conventional
antipsychotics, patients on olanzapine or risperidone had higher
quality of life scores than patients on haloperidol.
ZS7.
MOOD DISORDERS IN IRAN: AN UPDATE
(organized by the WPA Central and Western Asia
Zone)
ZS7.1.
A BIBLIOMETRIC ANALYSIS OF RESEARCH
ON MOOD DISORDERS IN IRAN
M. Amin Esmaeili, S.S. Gudarzi, N. Mahdavi
Mood Disorder Section, Iranian Psychiatric Association
The studies on the burden of disease in Iran revealed that psychiatric
disorders ranked the second among all medical illnesses. Depressive
disorders were shown to be the most disabling disease among
women. To define a prospective view of the studies on mood disorders
in Iran, we performed a bibliometric study on the relevant literature.
All the papers from Iran which were published in the national
and international scientific journals were assessed. Two Iranian databases,
Iranmedex and Iranpsych, and two International databases,
Medline and Embase, were searched. All the articles were assessed by
three psychiatrists with good inter-rater reliability. In total, 973 articles
achieved the inclusion criteria. The subject of articles was depressive
disorder (78.4%), bipolar disorder (7.8%) and suicide (10.2%).
An increasing trend in publications on mood disorders in Iran was
found. Most of the studies have targeted depressive disorders. The
most substantial increase was found in epidemiological studies (representing
53.8% of the total). The methodology of the studies was
descriptive in 32.8% of cases, descriptive/analytic in 39.5% and analytic
in 28%. An increase in published research on bipolar disorders
has only started since 2000. The rate of publications in international
journals has shown a sharp increase since 2000. Nevertheless, considering
the prevalence of mood disorders in Iran, the whole scientific
output remains insufficient.
ZS7.2.
DEPRESSION IN THE IRANIAN CULTURAL
CONTEXT
H. Davidian
University of Tehran, Iran
The prevalence of depressive disorders in the general population in
Iran is about 10%. About 10% of the patients seen by general practitioners
suffer from depression, 50% of whom remain undiagnosed. 30-
60% of the patients admitted to general hospitals for physical illnesses
125