Insight and Attitude towards Drug Intake:Risk Factors for Relapse in Patients with Psychosis - A Pilot Study Report

Background and objectives:

The identification of the major risk factors for relapse in patients with psychosis became inevitable in order to manage the illness effectively. This will not only enhance our understanding of the course and the prognosis of the illness, but also help us to frame guidelines and protocols to prevent relapse in psychosis. Hence, the present study was undertaken with an objective of determining the major risk factors for relapse in psychosis such as level of insight and the attitude towards drug intake.

Materials and Methods:

In order to determine the major risk factors for relapse in patients with psychosis, a case-control study design was adopted for the present study. Subjects included in the study group (relapse group) were inpatients with a history of at least one episode of psychosis in the past and with symptoms of relapse in the past two months. In the control group (non-relapse group) outpatients without symptoms of relapse in the past six months and on regular treatment were included. Convenience sampling technique was used to select 15 subjects for the study group and 15 subjects for the control group. An interview guide was used to obtain the baseline socio-demographic and clinical variables. Drug attitude inventory scale (DAI-10) and schedule for assessment of insight (SAI) were used to assess the attitude towards drug intake and insight respectively.

Results:

There was a highly significant association between the subjects attitude towards drug intake and relapse in psychosis (p<0.001). There was a statistically significant association between insight into illness and relapse in psychosis (p<0.005). It was also found that there were a highly statistical differences in the adequacy of insight into illness and the attitude towards drug intake between the relapse group and the non-relapse group.

Conclusions:

The findings of the present study concluded that, inadequate insight and unfavorable attitude towards drug intake predominantly contributes as the major risk factors for relapse in patients with psychosis. Moreover, it was evident that insight into illness and the attitude towards drug intake are inter related in a way that adequate insight into illness would directly contribute to a favorable attitude towards drug intake, thereby increasing the medication compliance and decreasing the relapse rate in patients with psychosis.