Psychosocial Correlates and Treatment Compliance in Depressive Disorder: A Hospital Based Study

Abstract

Introduction: Depressive disorder is a common mental illness seen in hospitals and mental health services in Nepal. The aim of the study was to determine the psychosocial correlates and treatment compliance in depressive disorder patients, coming to Tribhuvan University Teaching Hospital, Kathmandu, Nepal.

Methods: Psychosocial profiles of 135 depressive disorder patients diagnosed by consultant psychiatrist according to ICD-10 and meeting the study criteria, attending out-patient clinic, Department of Psychiatry and Mental Health, Teaching Hospital, were included. The study sample were randomized into three different groups; i.e. cognitive behavior therapy, pharmacotherapy or combined therapy (receiving both cognitive behavior therapy and pharmacotherapy). Psychosocial correlates, illness characteristics and treatment compliance in depressive disorder were assessed by Semi-Structured Interview Schedule, Beck Depression Inventory, Automatic Thought Questionnaire-Revised and Visual Analogue Scale, by comparing the pre and post therapy results and drop- out rates.

Results: Before therapeutic interventions, 53(39.3%) had moderate, 47(34.8%) had severe depressive and 35(25.9%) had mild depressive symptoms. Negative automatic thoughts, hopelessness, anxiety and inability coping; low socio-economic assets and education; relationship and adjustment problems and significant life events were significant psychosocial correlates of depression. Compliance was poor in the pharmacotherapy group. Total 30 (22.2%) patients had dropped-out during the study period: 15(33%) from pharmacotherapy, 11(24%) from Cognitive Behavior Therapy and 6(13%) from combined therapy group.

Conclusion: Psychosocial factors were significantly correlated with depressive disorder. Compliance to treatment and recovery was better in the combined therapy group than either therapy alone.