Adherence and Treatment Outcomes among Patients of Depression with Co-Morbidity from Kandahar, Afghanistan


Authors : Dr. Masood Ahmad Noushad.

Volume/Issue : Volume 3 - 2018, Issue 12 - December

Google Scholar : https://goo.gl/DF9R4u

Scribd : https://goo.gl/55ZDTE

Thomson Reuters ResearcherID : https://goo.gl/KTXLC3

I. BACKGROUND Psychological well-being is a term used to depict either a dimension of intellectual or passionate prosperity or a nonattendance of a psychological issue. Psychological wellness is an outflow of one’s feelings and means an effective adjustment to a scope of requests. The World Health Organization (WHO) characterizes psychological wellness as “a condition of prosperity in which the individual understands his or her own capacities, can adapt to the typical worries of life, can work profitably and productively, and can make a commitment to his or her locale”. 1ICD-10 There are at present two generally settled frameworks that characterize mental scatters — , part of the International Classification of Diseases created by the WHO, and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) delivered by the American Psychiatric Association (APA). These arrangements incorporate an extensive variety of emotional well-being issue. Since national and sub-national studies in Afghanistan have discovered high rates of sadness, uneasiness and post-awful pressure disorders– with no less than one of these influencing half of the populace matured 15 years or more seasoned, for handy purposes in this paper the term psychological well-being is limited to these conditions in addition to epilepsy, the pervasiveness of which is likewise high. Delayed clash and common war in Afghanistan have prompted expanded predominance of the in advance of referenced emotional well-being issue. In spite of the fact that the Kandahar family has been extremely influenced by the war from most recent 40 years, there is proof of absence of distributed research deals with the help that families give to their ill relatives. The dimension of social pressure that the patients encounter from their social condition, the adherence and treatment results in patients experiencing mental scatters and their comorbidities have not yet been experimentally examined in the Kandahar . II. METHOD This was a pseudo-longitudinal study, in which repeated measurements on adherence to treatment; treatment outcomes and level of functioning variables were carried out on each patient who participated in the study in the period between December 2017 and May 2018. The researcher and his assistants did not carry out any intervention on any patient. The participants were under their usual treatments prescribed and administered by the hospitals clinicians and other health workers at the said psychiatric facilities. The patients came from all over the province and beyond to seek services at the study site. From last six months every month 400 patients were attended this study site. The study sites were Darul sehat clinic in Kandahar in the Southern Western Province of Afghanistan. III. RESULTS This study sought to achieve specific objectives and test the hypotheses. and also We obtain the exact number of cases of Co-Morbidity of depression to other mental health disorders and we found during this study the relationship of treatments and adherence of Co-Morbidity of depression in Kandahar Afghanistan and finally we determined the factors that influence adherence to treatment among patients in Kandahar Afghanistan. IV. CONCLUSION The prevalence of Co-Morbidity of depression and other mental or neurological disorders was 31.4% where 17.9% had Co-Morbidity of depression and other mental disorders (without neurological disorder), 12.2% had Co-Morbidity of depression and other neurological disorders (without other mental disorders) and 1.3% had Co-Morbidity of depression, other mental and neurological disorders. The overall level of adherence to treatment was 65.8% which indicated that the patients in Kandahar did not adhere optimally to treatment. Only 32.5% of patients achieved optimal adherence, a rate that is lower compared to developed countries. The vast majority of patients missed scheduled clinical appointments and other non-pharmacological treatments and post- treatment follow-ups. It emerged that the main significant factors influencing (hindering or promoting) adherence to treatment among patients in Kandahar were side effects associated with medication, the affordability of treatment regimen, poor fit between treatment requirements and patient’s lifestyles or daily routine, communication, attitudes of service providers, availability of appointment staff, Co-Morbidity of depression and other disorders, being busy, forgetfulness, travelling, social support, having problems in social environment, having relatives who were stressful, having problems with (barriers to) access to healthcare services . The adherence to treatment was significantly related to relapse and re-hospitalization. The study concluded that there was a weak significant relationship between adherence to treatment and treatment outcomes among patients.

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