Noncompliance with iron chelation therapy in patients with beta thalassaemia

Twenty-three percent of patients with beta thalassaemia were found noncompliant to iron chelation. Excluding separation anxiety disorder and primary functional enuresis, the frequency of psychiatric disorders in the noncompliant and the compliant patients was 68% and 10%, respectively. Oppositional disorder was the most frequent psychiatric disorder; it was also associated with the most profound deviation from compliance. Separation anxiety disorder and primary functional enuresis were not associated with noncompliance. In one-third of the noncompliant patients no psychiatric disorder was identified. School performance was poorer in the noncompliant patients. The presence of psychiatric disorders (mainly oppositional disorder), other than separation anxiety disorder and primary functional enuresis, in thalassaemic patients is a risk factor for noncompliance to treatment. Early identification of noncompliance and appropriate psychiatric intervention may help these patients to become compliant with medical treatment.