Intimate partner violence prevalence and its effect on medication adherence and relapses among patients with chronic mental disorders at Ndera Neuropsychiatric Hospital, Kigali, Rwanda

Abstract

INTRODUCTION: Intimate Partner Violence (IPV) is a global public health issue with severe consequences, particularly for individuals with chronic mental disorders. This study aimed to assess the prevalence of IPV among patients with chronic mental disorders at Ndera Neuropsychiatric Hospital in Rwanda and examine its impact on medication adherence and relapse rates. 

METHODS: A cross-sectional study was conducted with 384 adult patients diagnosed with chronic mental disorders. Participants were screened for IPV using the Hurt, Insult, Threaten, Scream (HITS) tool, while medication adherence was assessed using the Medication Adherence Rating Scale (MARS). Relapse rates were determined through a retrospective review of medical records. Descriptive and inferential statistics, including logistic regression, were used for data analysis. 

RESULTS: The prevalence of IPV among participants was 28%, with women more affected than men (40.6% vs. 10.6%). Poor medication adherence was reported by 32% of participants, and 51% had at least one relapse in the past 12 months. Patients experiencing IPV were 2.8 times more likely to be non-adherent to medications (OR=2.85; 95% CI: 1.74- 4.65; p<0.001) and 3.48 times more likely to relapse (OR=3.48; 95% CI: 2.14-5.65; p<0.001). 

CONCLUSION: The study highlights the high prevalence of IPV among individuals with chronic mental disorders, particularly women, and its detrimental effects on treatment outcomes. Integrated interventions addressing IPV and mental health, alongside gender-sensitive policies and community support programs, are urgently needed to improve medication adherence and reduce relapse rates in this vulnerable population.