ABSTRACT
Background: Depression, a common mental disorder characterized by persistent unhappiness and lack of interest in daily activities, is one of the major important public health problems that are often comorbid with other chronic diseases like diabetes and can worsen the effect of the disease outcomes. Depression alone and/or as a comorbidity with diabetes is a common condition in the community. Aim of the study: To identify the prevalence of Depression among Type 2 Diabetes Mellitus patients and relationship between Depression and its effect on Drug Compliance among Type 2 Diabetes Mellitus patients, to determine the severity of Depression among Type 2 Diabetes Mellitus patients and the extent to which it affects Drug compliance. Materials and methods: The study was to be conducted in Rajah Muthiah Medical College and Hospital, Chidambaram in the year 2018-2019. A hundred patients with diagnosis of T2DM attending Diabetic OPD above 20 years of age were randomly selected. The Hamilton rating scale for depression by Hamilton is the most widely used rating scale to assess the symptoms of depression. The Ham-D is an observer-rated scale consisting of 17-21 items. Ratings are based on clinical interview. The items are rated on either a 0 to 4 spectrum or a 0 to 2 spectrum. The HAM-D also relies quite heavily on the clinical interviewing skills and the experience of rater in evaluating individuals with depressive illness. The strength of HAM-D is its excellent validation/research base, K.H. Mohamed Ibrahim, R. Gandhi Babu, M. Senthil Velan. Prevalence of psychiatric morbidity (depression) and its effect on drug compliance among patients attending diabetic outpatient clinic. IAIM, 2019; 6(11): 19-28. Page 20 and case of administration. Its use is limited in individuals who have psychiatric disorders other than primary depression. Results: Analyzing with HAMD score, 40 had no depression, mild depression in 24 cases, moderate depression in 21 cases, severe depression in 15 cases. MAQ score scale- low adherence in 41 cases, medium adherence in 37 cases, high adherence in 22 cases. MMAQ score scale and HAMD scorelow adherence with no depression were 9 cases (22.5%) mild depression were 6 cases (25%) moderate were 11(52.4%) severe depression were 15 cases (100%). MMAQ score scale and HAMD score - medium adherence with no depression were 23 cases (57.5%) mild depression were 9 cases (37.5%) moderate were 5(23.8%) severe depression were not seen. MMAQ score scale and HAMD score - Medium adherence with no depression were 8 cases (20%) Mild depression were 9 cases (37.5%) Moderate were 5(23.8%) severe depression was not seen. Pearson Chi-Square = 35.344**, p<0.001. Conclusion: Further, there was a significant association between the depression in Type 2 diabetes patients and medication adherence, where patients with depression had poor medication adherence as compared to those without depression and severity of depression correlates with worse adherence to diabetic medications
ABSTRACT
Background: Schizophrenia is one of the most devastating mental disorders that impair language, thinking, perception and sense of self. Recent estimates suggest that around 1% of the adult population that is around 21 million people is suffering from this disabling disease. In India, caregiving is mainly by family members because there are limited alternatives in institutional facilities and welfare supports for those with chronic illnesses such as mental disorders. Most Indian families prefer to care for ill persons at all stages of illness. But, the changing society places significant demands on the caregivers. Aim of the study: To study the prevalence of anxiety and depression among caregivers of schizophrenia patients. To find the association between anxiety and depression of caregivers with the duration of illness, severity of illness (schizophrenia) and the years of association with the patients. Materials and methods: The study was conducted among patients of schizophrenia and their K. Arun Kumar, R. Gandhi Babu, M. Asok Kumar. Prevalence of anxiety and depression among the primary caregivers of patients with schizophrenia who attended Psychiatry Outpatient Department at Rajah Muthiah Medical College and Hospital, Chidambaram. IAIM, 2019; 6(11): 63-75. Page 64 caregivers attending Psychiatry Outpatient Department Rajah Muthiah Medical College and Hospital, Annamalai University, A hundred patients with a diagnosis of schizophrenia and their primary caregivers had been consecutively selected from Psychiatry Outpatient department, Rajah Muthiah medical college, Annamalai university in the year 2018-2019. Then the Self innovated proforma was filled and details about the patients and their caregivers were obtained. HAM-D and HAM-A scales were administered for caregivers and scored for the level of psychiatry morbidity among them. BPRS scale was administered for patient and the severity of illness was assessed. The prevalence was then compared with different variables and associations if any was found. Results: In 100 peoples, Ham- A anxiety score level was analyzed. Severe anxiety was seen in 8 persons, mild to moderate anxiety was in 9 caretakers. Mild severity was observed in 83 patients. Pearson Chi-Square=27.936**, p<0.001. Depression score was absent and less significant among 61 caretakers, mild depression was observed in 24 peoples, moderate depression in 7 caretakers, severe depression was observed in only 8 cases. Paranoid type is more which was around 64%, hebephrenic was 11 %, residual -7%, simple -7%, undifferentiated -7%, catatonia-4%. BPRS score was < 31 in 74 patients, 31-42 were 12 cases, > 43 in 14 patients. More than 10-20 years in people who were taking care of ill patients had severe anxiety when compared to 1-3 years, up to 1 year, 3-10 years. Pearson Chi-Square = 9.784, P = 0.134 which was statistically significant. Severe depression was seen in the illness of 10-20 years in (8) cases. Up to 1 Year, 1-3 Years, 3-10 Years, 10-20 Years had less incidence of severe depression. Few peoples had less depression, mild, and moderate depression. Pearson Chi-Square = 15.405, P = 0.080 which was statistically less significant. Conclusion: Psychiatric disorders were prevalent amongst caregivers who are first- degree relatives of schizophrenic probands. BPRS Score of the patient gave the best diagnostic accuracy for screening psychiatric morbidity and increased the probability of finding a psychiatric disorder in caregivers. Therefore, routine screening of caregivers will aid early diagnosis of psychiatric disorders and enable timely psychological intervention.