Cross-sectional study of internalised stigma and medication adherence in patients with obsessive compulsive disorder

Gen Psychiatr. 2020 Mar 11;33(2):e100180. doi: 10.1136/gpsych-2019-100180. eCollection 2020.

Abstract

Background: Patients suffering from psychiatric disorders tend to stigmatise themselves which had been linked to poor adherence to treatment.

Aims: The aim of the present study was to study internalised stigma and medication adherence and to assess the relationship between them in patients with obsessive compulsive disorder (OCD).

Methods: A cross-sectional study was conducted on 112 patients diagnosed with OCD who were attending the Out-patient's department at Department of Psychiatry of a tertiary care hospital in North India. Internalised stigma and current medication adherence were assessed with Internalized Stigma of Mental Illness Scale (ISMI) and Medication Adherence Rating Scale, respectively. Yale-Brown Obsessive Compulsive Scale was used to assess the current severity of OCD symptoms. Sociodemographic and clinical details were also obtained from the patients by using a semistructured sociodemographic proforma.

Results: Most of the patients reported moderate level of internalised stigma with a mean ISMI score of 77.98 (10.82). Most of the patients were compliant while 41.96% reported poor medication adherence. Internalised stigma was negatively correlated with the current medication adherence. Current severity of OCD symptoms also showed a significant positive correlation with internalised stigma and a significant negative correlation with medication adherence.

Conclusion: High levels of internalised stigma were associated with lower adherence to treatment which suggests that internalised stigma may be a very important factor influencing medication adherence in patients with OCD.

Keywords: medication adherence; obsessive-compulsive disorder; social discrimination.