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

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(0CD).Methods A cross-sectional study was conducted on 112 patients diagnosed with 0CD 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.

Phenomenology,disability and sexual functioning in female Dhat syndrome:a study of tertiary care gynaecology outpatients

Background Dhat syndrome,a clinical condition related to semen loss in urine often found among males in India,has rarely been described as a separate clinical condition in females.Women with the syndrome complain of passing vaginal discharge and can be excessively concerned and preoccupied with it,often attributing various physical symptoms to the loss of vaginal fluids.Aims This study aimed to assess the sociodemographic and clinical profiles of female patients with Dhat syndrome and their perceived stress,disability and sexual functioning.Methods Sociodemographic details of 70 females with non-pathological vaginal discharge were evaluated with a semistructured sociodemographic assessment.The phenomenology of the vaginal discharge was assessed with the Scale for Assessment of Female Dhat Syndrome Questionnaire.Anxiety and depressive symptoms were measured with the Hospital Anxiety and Depression Scale.Perceived stress in the past month and disability caused by the illness were assessed with the Perceived Stress Scale and the World Health Organization Disability Assessment Scale.In addition,the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition,Level 2 Somatic Symptoms Scale was administered to rate the severity of somatic symptoms,and sexual functioning was evaluated using the Female Sexual Function Index(FSFI)scale for women who had had sexual intercourse in the past month.Results The mean age of onset vaginal discharge was 23.0(6.6)years.Biological factors,such as urinary tract infection,were the commonly attributed cause of the loss of vaginal fluids.Psychiatric comorbidity and perceived moderate stress in the past month were found in 38.6%and 68.6%of female patients with Dhat syndrome,respectively.Disability scores tended to be low.Among the females having had sexual intercourse in the past month,48.3%had FSFI scores indicative of a female sexual disorder.Conclusions The clinical presentation of women with non-pathological vaginal discharge is similar to that of males with Dhat syndrome.It requires comprehensive assessment and management that targets the biological,social and psychological factors and cultural issues.