Canadian Psychiatric Association

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Guest Editorial
Modern Views of Autism

Eric Fombonne


In Review
Autism Spectrum Disorders: Early Detection, Intervention, Education, and Psychopharmacological Management

Susan E Bryson, Sally J Rogers, Eric Fombonne


Diagnosis and Epidemiology of Autism Spectrum Disorders
Lee Tidmarsh, Fred R Volkmar


Genetic and Neurodevelopmental Influences in Autistic Disorder
Rob Nicolson, Peter Szatmari


Original Research
Attitudes of Senior Psychiatry Residents Toward Persons with Intellectual Disabilities

Hélène Ouellette-Kuntz, Philip Burge, David B Henry, Elspeth A Bradley, Pierre Leichner


The Efficacy of 2 Different Dosages of Methylphenidate in Treating Adults With Attention-Deficit Hyperactivity Disorder

Rachelle Bouffard, Lily Hechtman,, Klaus Minde, Fiorella Iaboni-Kassab


Delirium in Hospital: an Underreported Event at Discharge

Louis T van Zyl, Paul R Davidson


Brief Communication
Removing Barriers to Treatment of First-Episode Psychotic Disorders

Derek J Scholten, Ashok K Malla, Ross MG Norman, Terry S McLean, Elizabeth M McIntosh, Chris L McDonald,, Michael Eliasziw, Kathy N Speechley


Book Reviews

Couple Therapy with Gay Men.
Reviewed by
Peter Moore, MD, FRCPC

What Forever Means After The Death of a Child.
Reviewed by
Philip Cheifetz, MD, FRCPC

Fighting for Mental Health: A Personal View.
Reviewed by
Paul Grof, MD, FRCPC

Understanding the Mind: The Nature and Power of the Mind. 2nd ed.
Reviewed by
Scott Bishop, PhD, CPysch Zindel Segal, PhD, CPsych

Letters to the Editor

Response of Catatonic Schizophrenia to Amisulpride: A Case Report

Medication Noncompliance Among Psychiatric Outpatients In Iran

Diogenes Syndrome in a Pair of Siblings

Treatment Option for Seasonal Affective Disorder

Factitious Anemia and Magnetic Resonance Imaging Abnormalities

Pregnancy and Respiratory Nocturnal Panic Attacks

Letters to the Editor

Medication Noncompliance Among Psychiatric Outpatients In Iran

Dear Editor:

Throughout the world, medication noncompliance is one of the major problems in psychiatric treatment. We have experienced this obstacle almost daily in our outpatient clinics in Iran. Medication noncompliance is defined as discontinuation of medications without physician recommendation. We should make clinicians aware that medication noncompliance is common and may be a relatively unpredictable phenomenon. Further, it can become a major treatment difficulty in psychiatric patients. We conducted a study in Kerman, Iran, which assessed 150 randomly selected psychiatric outpatients for medication noncompliance. Of the subjects, 56 (37.4%) had a history of early discontinuation of psychotropic medications. Medication noncompliance was more frequent in patients with primary school education than in those with high school education. False beliefs about psychotropic medications were significantly higher in patients who discontinued their treatment before the appointed time than in patients who continued.

The most prevalent false belief is that psychotropic medications are addictive. According to diagnosis, the highest rate of early discontinuation was seen among patients with depressive disorders. A high rate of medication noncompliance was also found in other studies (1,2).

Hopelessness, an important symptom, may be responsible for medication noncompliance in patients with depressive disorders. A false belief in psychotropic medications is a contributing factor to medication noncompliance in our country.

Patient compliance is an important factor for better therapeutic success; thus, for improved outcome, we recommend that psychiatrists evaluate patient compliance before prescribing psychotropic medications.


1. Gillis LS, Trollip D, Jakoet A, Holden T. Non-compliance with psychotropic medication. S AFR Med J 1987;72:602–6.

2. Ghazziuddin N, King CA, Hovey JD, Zaccagnini J, Ghaziuddin M. Medication noncompliance in adolescents with psychiatric disorders. Child Psychiatry Hum Dev 1999;30:103–10.

Alireza Ghaffari Nejad, MD
Fatemeh Pouya, MSc
Kerman, Iran

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