PATIENTS WITH CHRONIC MENTAL-ILLNESS ATTENDING OUTPATIENT GROUPS - FACTORS INFLUENCING COMPLIANCE

Objectives. To determine the factors contributing to poor patient comp liance in patients with chronic mental illness attending outpatient gr oups. Design, A single-centre prospective study in which patients who participated in outpatient groups were followed up during a 3-month pe riod. Personal information and compliance were documented and question naires completed by the patients. Setting, Oranje Hospital, psychiatri c outpatient department, Patients. 106 patients attending Oranje Hospi tal outpatient department. Results, Of the 106 patients participating in the study, the majority suffered from depressive disorders (30%) an d schizophrenia (31.1%). Anxiety disorders and bipolar mood disorder a ccounted for 16% each. The median age of the patients was 47 years and the median time of attendance 23 months. The majority of the patients were satisfied with the group meetings. The reasons given for non-att endance were predominantly acceptable. Patients were divided into comp liant and non-compliant members. Only slight differences were found wh en these groups were compared. Conclusion, Faulty compliance is not a trivial issue, as it accounts for significant economic loss and clinic al morbidity. Findings of compliance studies in patients with psychiat ric disorders closely resemble those in medical conditions, In psychia tric patients lack of insight and delusional ideas may contribute to n on-compliance. Increased compliance Is associated with patient satisfa ction, level of supervision, patient's view of the disorder, and famil y influence and stability. Decrease in compliance is to be expected wh en the treatment regimen is complex, and when there are side-effects, social isolation, substance abuse and increased duration of therapy.