1 TC Sağlık Bakanlığı Bakırköy Prof. Dr. Mazhar Osman Ruh Sağlığı ...

SUMMARY
Almost for all disease, especially for chronic ones, compliance is an important factor
prevents the success of treatment. While non-compliance and no-show in outpatient follow up
appointments declared as 20% - 50% for psychiatric patient populations, it can be 70% - 80%
for psychotic patients. For all disease, especially for psychotic patients without insight, there
are many factors affecting compliance which can be classified as personal problems and
problems concerning family, health system and side effects of medication.
In light of this information, patients hospitalized at least two times to psychosis in-
patient clinics of BMH between 01.03.06 – 31.05.08 with chronic psychotic disorder
(Schizophrenia, schizoaffective disorders, paranoid disorders and atypical psychotic
disorders) diagnosis and have the same diagnosis at their last two hospitalizations are selected
for our survey. Brief psychotic disorders, mental disorders due to general medical condition
not elsewhere classified, substance induced psychotic disorders and mental retardation cases
are excluded. 4453 patients meet the criteria are detected.
Initially, comparing with patient lists of outpatient clinics, 2114 patients (47,4% of
4453) who have not attended to any appointment in 6 months after discharge are listed and
randomly 350 of them selected for our survey. Socio-demographics, telephone numbers and
variables of disease profiles (appendix, form no. 1) are retrieved from hospital archives.
Patients and relatives are interviewed by telephone with questionnaire (appendix, form no. 2)
prepared according to related literature.
In total, 305 people (23 patients and 285 patient relatives) are interviewed and it’s
observed that 24 of our sample were dead and 15 people are missing. With rest of the sample,
reasons of chronic psychotic patients for no-show in outpatient follow up appointments in
BMH and reasons for treatment non-compliance after discharge from our hospital are tried to
be understood. Obtained results are discussed in the light of recent literature and some
suggestions about what can be done to increase follow-ups, treatment compliance, quality of
life and functionality of chronic psychotic patients are proposed.
Key words: chronic psychotic disorders, non attendence to first appointment, after
discharge, out patient follow-up, noncompliance.
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