• Rizwan Taj
  • Saleem Khan


Background: This study was carried out with an objective to find out the frequency of different reasons of non-compliance to treatment in a sample of out door psychiatric patients. Methods: This study was conducted at Psychiatry department, Pakistan Institute of Medical Sciences, Islamabad, from Aug, 2001 to Jan, 2002. Data from a non-probability sample of two hundred follow up patients with a definite psychiatric illness was collected. A questionnaire designed for this purpose was administered by a consultant psychiatrist to the patients. The data was categorized into different causes of discontinuation of treatment accordingly. Results: The commonest reasons for non-compliance were unawareness of the benefits of treatment (43%), nonaffordability of drugs (33.5%), physical side effects (28.5%), no awareness given by the doctor (03%) and unfriendly attitude of doctors (02%).  The commonest illnesses leading to non-compliance were major depressive disorder (31.5%), schizophrenia (19.5%) and bipolar affective disorder (19%). Conclusion: Non-compliance is quite common in Pakistan like any other society. Medical practitioners need to be aware of it and address this problem because compliance is directly related to the prognosis of the illness. It is recommended that all efforts should be exerted to improve the compliance of psychiatric patients by eliminating the factors leading to non-compliance.KEYWORDS: Non-compliance, Psychiatric illnesses, Treatment. 


Kaplan HI, Sadock BJ. Synopsis of psychiatry. 8thed. New Delhi: BI Waverly 1998.

Porter RJ. General principles: how to use antiepileptic drugs. In:Levy RH, Dreifuss FE. Antiepileptic drugs. 3rd ed. New York: Raven Press 1989..

Matsui DM. Drug compliance in paediatrics. Pediatr Clin North Am 1997;44: 1-14.

Spagnoli A, Ostino G, Borga AD. Drug compliance and unreported drugs in the elderly. J Am Geriatr Soc 1989;37:619-24.

Maronde RF, Chan LS, Larsen FJ, Strandberg LR, Laventurier MF, Sullivan SR. Underutilization of antihypertensive drugs and associated hospitalis-ation. Med Care 1989;27:1159-66.

Lacombe PA, Vicente JAG, Pages JC, Morselli PL. Causes and problems of non response or poor response to drugs. Drugs 1996;51:552-70.

Morris LS, Schulz RM. Patient compliance - an overview. J Clin Pharm Ther 1992;17:283-95.

Billups SJ, Malone DC, Carter BL. Relationship between drug therapy non-compliance and patient characteristics, health-related quality of life and health care costs. Pharmacotherapy2000;20:941-9.

Weiden PJ, Shaw E, Mann J. Causes of neuroleptic non-compliance. Psychiatric Annals 1986;16:571-5.

Soumitra RP, Carol P. Psychotropic drug treatments. ABC of Mental Health 1998; 71.

Elixhauser A, Eisen SA, Romeis JC, Homan SM. The effects of monitoring and feedback on compliance. Medical Care 1990; 28:883- 93.