Background:
Women with schizophrenia have needs beyond their mental health needs, such as those arising out of their gender, sexual, and reproductive functions. Very little is known about the knowledge, attitude, and practice regarding contraception among women with schizophrenia from India.
Materials and Methods:
Study among women with schizophrenia (in reproductive age group, having at least one living child, and currently staying with husband) from south India explored their knowledge, attitude, and practice of contraception. Adhering to observational design and ethical principles, data were collected using a semi-structured questionnaire. Modified National Family Health Survey-3 questionnaire and Positive and Negative Symptom Scale of Schizophrenia were also used.
Results:
Ninety-six women with schizophrenia participated. The mean age was 33.5 years [standard deviation (SD): 6.8 years], and the mean age of onset of schizophrenia was 29.2 years (SD: 6.2 years). Although nearly 90% had knowledge on at least one method of contraception, the mean total number of methods known was mere two. Out of 65 women who were practising contraception, 86.2% adopted female sterilization. The common reasons for not using contraception were wish for another child/son, lack of awareness, and fear of side effects. Unmet need for family planning was 14%. Informed choice of contraception was below 3%. There was statistically significant association between those who were currently using contraception and variables such as age 31 years and above, undifferentiated subtype of schizophrenia, and greater severity of schizophrenia.
Conclusion:
Although the majority had some knowledge about contraception, decision-making largely rested with others, and informed choice regarding contraception was poor. These could pose an obstetric risk on women with schizophrenia. Sociocultural and illness-related factors influencing contraception need to be explored.
There is high prevalence of psychological distress in patients diagnosed with neurological disorders. A cross-sectional study was done among inpatients from the department of neurology in a tertiary care centre in South India to assess prevalence of anxiety, depression, and barriers to mental health-care utilization. Anxiety and depression were estimated using the Hospital Anxiety and Depression Scale (HADS). There is a high prevalence of psychological distress among the study participants. Proactive inquiry and screening of distress by the treating team may help identify psychological distress. Patients are more conforming and open to treating doctor. Barriers to mental health-care utilization included stigma, patient perception regarding treating doctor's attitude, patients' perception regarding distress, and doctor's perception regarding patient distress. There is a need for measures to alleviate stigma.
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