Jeeva Sebastian
Christian Medical College, India
Title: A study to associate relapse with attitude towards medication, explanatory models among people with schizophrenia and their care giver knowledge regarding schizophrenia
Biography
Biography: Jeeva Sebastian
Abstract
Background: Schizophrenia is a severe mental disorder affecting more than 21 million people worldwide. It is associated with considerable disability and may affect educational and occupational performance. Pharmacological and non-pharmacological measures are being used to treat the mental illness. Caregivers who are the primary interface with the health care system often receive inadequate support from health professionals and frequently feel abandoned and unrecognized by the health care system.
Aims: To identify factors associated with relapse in patients with schizophrenia and their care givers.
Method: Cross sectional design was used to recruit 100 consecutive patients with schizophrenia who were currently suffering with relapse along with their care givers who had consented, based on inclusion criteria. Drug Attitude Inventory (DAI-10), Knowledge about Schizophrenia Interview (KASI) and Short Explanatory Model Interview (SEMI) scales were used to assess the factors associated with relapse. Data was analyzed using SPSS for Windows 21. Frequencies, percentages and descriptive statistics were used for the variable description, Chi square test used for finding the association between the variables of interest.
Results: Care givers knowledge: Most of the care givers ( 49%) reported that the patients’ diagnosis was ‘some mental illness’, 44% of them were not aware of the signs and symptoms , 45% of them believed that the illness was due to non-medical causes ( black magic, loss of loved ones, adjustment problem, financial problem, stress, love failure, failure in examination ,marriage related problems and ancestral spirit), 42 % of them were not aware of the medicines taken by their relative(s) (name, frequency, dosage etc.,), 47 % of them were not aware of recurrence, prognosis and many of them were over protective and 14% of them had an idea about supportive therapy. In this study caregivers’ education is significantly associated with awareness of diagnosis (p value <0.001), signs and symptoms (p value=0.001), and etiology of illness (p value=0.004). Occupations of caregivers are significantly associated with awareness of diagnosis (p value =0.019) , etiology of illness ( p value = 0.011). Caregivers’ knowledge about etiology is associated with recovery of the patient from the past episode (p value = 0.004) and knowledge about medication is significantly associated with recovery in the past episode (p value =0.010).
Illness Model: Majority of the Patients believed that the cause of illness was evil spirits (25 %), followed by black magic (15 %), punishment from God (12 %) and karma (11 %). 37 % of them believed that the illness is due to biochemical causes (brain problem, chemical changes in the brain) or genetics .This shows that majority of the subjects (63 %) held non-medical model.
Patients attitude towards antipsychotic drugs: Majority (62%) of the patients had a negative attitude, 21% of them had positive attitude, while 17% of them had a neutral attitude towards the consumption of antipsychotic drugs. In this study, the attitude of patients towards antipsychotic was not significantly associated with any of their socio demographic variables.
Conclusions: This study highlighted the perceptions about schizophrenia, attitude towards anti psychotics and their care givers knowledge about schizophrenia. It shows that there is a significant relationship between relapse with illness model, attitude towards drug and care givers knowledge about schizophrenia. Management of patients with schizophrenia can be improved by addressing the factors influencing relapse as highlighted in this study.