Non-adherence to depression treatment is a common clinical problem globally. However, limited research is available from India. This cross-sectional study aimed to assess non-adherence to prescribed treatment among patients with unipolar depression at a psychiatric out-patient department (OPD) of a tertiary hospital in Kolkata, India. The Morisky Medication Adherence Scale (MMAS) was used and a questionnaire designed by the Principal Investigator (PI) was administered. A total of 239 patients with unipolar depression were interviewed of whom 66.9% (160) were non-adherent and 33.1% (79) were adherent to treatment. The difference was significant (Fisher’s Exact ). Women were nearly three times at a higher risk of being non-adherent compared to men (OR 2.7; 95% CI 1.0–7.1). The non-adherent group compared to the adherent group was significantly more likely to consume extra medicines than the recommended amount (OR 2.8; 95% CI 1.1–7.3) and had lower internal locus of control (LOC) (OR 4.5; 95% CI 2.4–8.3). Adherence to prescribed treatment in an out-patient clinical setting was a problem among patients with unipolar depression. Suitable interventions on individuals with the above mentioned attributes are required in India and in similar settings where non-adherence to depression therapy is an important public health problem. 1. Introduction Adherence (“extent to which a person’s behaviour corresponds with medical or health advice provided by a health care provider”) [1, 2] to therapy is emerging as a major public health challenge globally—both for communicable (tuberculosis, HIV/AIDS) and noncommunicable (depression, diabetes) diseases. The consequences of poor/non-adherence are extensive. It negatively impacts treatment effectiveness thus resulting in poor therapeutic outcomes. Non-adherence in some instances could result in serious complications requiring the individual to be hospitalised. This not only adds considerable physical strain and mental agony to the individual and the family but results in economic burden as well. It also adds pressure on the health system. Moreover, research indicates medication non-adherence may have a damaging effect on the individual’s health related quality of life (QOL) [3]. Non-adherence to treatment is a well-documented issue in the care of unipolar or major depression. According to World Health Report, 1999 [4] and the Global Burden of Disease (GBD) Update, 2004 [5] in 1990, depression was the fourth leading cause of overall disease burden and is emerging as a major public health challenge with regard to its
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