Depressive and bipolar disorders: patients' attitudes and beliefs towards depression and antidepressants

Kessing, Lars Vedel; Hansen, Henrik Lyngbeck; Demyttenaere, Koen; Bech, Per

doi:10.1017/s0033291705004605

Cited by 70 publications

(51 citation statements)

References 26 publications

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“…This corroborates earlier reports on treatment preference by individuals seeking treatment for MDD (Kessing et al, 2005;Raue et al, 2009;van Schaik et al, 2004). Congruence between the treatment patients prefer and the treatment they actually receive is generally considered as a positive prognostic indicator of outcome (Raue et al, 2009).…”

Section: F Peeters Et Al / Journal Of Affective Disorders ] (]]]]) supporting

confidence: 89%

The clinical effectiveness of evidence-based interventions for depression: A pragmatic trial in routine practice

Peeters

Huibers

Roelofs

et al. 2013

Journal of Affective Disorders

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a b s t r a c tBackground: Controversy persists about how effectively empirically-supported treatments for major depression work in actual clinical practice as well as how patients choose among them. We examined the acute phase effectiveness of cognitive therapy (CT), interpersonal psychotherapy (IPT), and combined psychotherapy-pharmacotherapy (PHT) in a naturalistic setting, allowing patients their choice of treatment. Methods: The study compared CT (n ¼ 63), IPT (n ¼56), CT-PHT (n ¼34), and IPT-PHT (n ¼21) for 174 subjects with major depression in a secondary care mood disorders clinic. Patient preference, rather than randomization, determined treatment selection. The Beck Depression Inventory-II (BDI) was the primary outcome variable. Exclusion criteria were minimal. Results: All treatments were associated with a reduction in depressive symptoms, with a 35% remission rate by week 26. Overall improvement was well within ranges reported in efficacy trials. On average, treatment effects of the different interventions straddled the same range, but moderation analyses revealed that BDI scores dropped faster in the first 16 weeks in patients who received CT alone than patients who received CT and pharmacotherapy, a pattern not found in patients who received IPT (with or without pharmacotherapy). Limitations: Limitations consist of a modest sample size, choice of treatment was made by participants which may have been influenced by many sources, and the absence of a non-active control group. Conclusions: This study supports the effectiveness of empirically-supported antidepressant treatments selected by patients in routine settings, and provides an indication that speed of therapeutic response may vary amongst treatments.

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Section: F Peeters Et Al / Journal Of Affective Disorders ] (]]]]) supporting

confidence: 89%

The clinical effectiveness of evidence-based interventions for depression: A pragmatic trial in routine practice

Peeters

Huibers

Roelofs

et al. 2013

Journal of Affective Disorders

View full text Add to dashboard Cite

show abstract

“…The response rate of 50% obtained in our study may appear low, but reflects other studies using patient response to mail-back questionnaires [34]. As discussed elsewhere [15], we do not believe that a major bias was operating in the selection procedure, as the responses did not vary according to age, type of disorder or number of hospitalisations.…”

Section: Discussionsupporting

confidence: 55%

“…The study is part of a comprehensive investigation which also measures general health, compliance and satisfaction with treatment [15]. The objective of the present study was to analyse the clinimetric properties of the enlarged BDI in this unselected sample of depressive (unipolar) and bipolar patients and focus only on the scales found valid by the psychometric analysis.…”

Section: Introductionmentioning

confidence: 99%

The Internalising and Externalising Dimensions of Affective Symptoms in Depressed (Unipolar) and Bipolar Patients

Bech

Hansen

Kessing

2006

Psychother Psychosom

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Objective: To analyse the internalising and externalising dimensions of affective states in depressed (unipolar) and bipolar patients approximately 2 years after discharge from psychiatric hospitals in Denmark. Method: The 42-item symptom scale based on the Beck Depression Inventory was used for the measurement of both the internalising dimension of affective symptoms (depression including suicidal ideas, anxiety and asthenia) and the externalising dimension (mania). To supplement the latter dimension, the WHO-5 questionnaire was included. These questionnaires were mailed to a large population of patients with depressive (unipolar) or bipolar disorders, representative of patients treated in hospital settings in Denmark, approximately 2 years after discharge from hospital. Results: In total, 244 unipolars and 214 bipolars were included in the study. Mokken analysis showed that depressive (unipolar) patients could be measured more validly than bipolar patients on the internalising subscales of depression, anxiety and asthenia. On the externalising dimension of psychological well-being (WHO-5), both groups of patients could be validly measured. Approximately 2 years after discharge from hospital, around 36% of the unipolars and 19% of the bipolars had a moderate to severe depression. In a control group of healthy subjects, 4% had a moderate to severe depression. Less than 5% even in the bipolar group of patients were hypomanic. Conclusion: Approximately 2 years after discharge from psychiatric hospitals in Denmark, depressive (unipolar) patients scored significantly higher than bipolar patients on the internalising dimension and suicidal ideas, and significantly lower on the externalising dimension of psychological well-being.

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“…Of all these factors, patients’ attitudes and personal beliefs regarding MDD and its treatment are thought to differ significantly between different cultures. Using the Antidepressant Compliance Questionnaire (ADCQ), Kessing et al [24] assessed the attitudes and beliefs of patients with depression and bipolar disorder towards their disease and its treatment. The study found that up to 80% of patients had erroneous beliefs regarding the effects of ADs.…”

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators of adherence to antidepressants among outpatients with major depressive disorder: A qualitative study

2017

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BackgroundOne of the major challenges in treating major depressive disorder (MDD) is patients’ non-adherence to medication. This study aimed to explore the barriers and facilitators of patients’ adherence to antidepressants among outpatients with MDD.MethodsSemi-structured and individual in-depth interviews were conducted among patients with MDD who were taking antidepressants, in the psychiatric clinic of a government-run hospital in Malaysia. Participants were purposively sampled from different genders and ethnicities. Interviews were conducted using a validated topic guide, and responses were audio-recorded, transcribed verbatim, checked, and analyzed using the grounded theory approach.ResultsA total of 30 patients were interviewed. Forty different themes and sub-themes were identified which were conceptually divided into two distinct categories related to barriers and facilitators to adherence. The barriers were: patient-specific, medication-specific, healthcare provision and system, social-cultural, and logistics. The facilitators were: having insight, perceived health benefits, regular activities, patient-provider relationship, reminders, and social support networks.ConclusionsPatient-specific barriers and medication side effects were the major challenges for adhering to treatment. Perceived health benefits and having insight on the need for treatment were the most frequently cited facilitators. Targeted interventions should be developed to address the key barriers, and promote measures to facilitate adherence in this group of patients.

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Depressive and bipolar disorders: patients' attitudes and beliefs towards depression and antidepressants

Abstract: Lack of knowledge about affective disorder and its treatment and a critical attitude, especially among older patients, may add to an adverse prognosis of depressive and bipolar disorders.

Cited by 70 publications

References 26 publications

The clinical effectiveness of evidence-based interventions for depression: A pragmatic trial in routine practice

The clinical effectiveness of evidence-based interventions for depression: A pragmatic trial in routine practice

The Internalising and Externalising Dimensions of Affective Symptoms in Depressed (Unipolar) and Bipolar Patients

Barriers and facilitators of adherence to antidepressants among outpatients with major depressive disorder: A qualitative study

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