Perceptions of and Attitudes Toward Antidepressants

Castaldelli-Maia, João Maurício; Scomparini, Luciana Burim; Andrade, Arthur Guerra de; Bhugra, Dinesh; Alves, Tania C. T. Ferraz; D'Elia, Gilberto

doi:10.1097/nmd.0b013e3182388950

Cited by 42 publications

(40 citation statements)

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“…Although data on medication adherence in FGID patients are sparse, our observed adherence exceeds the 29–45% reported for patients with non-GI functional disorders, such as fibromyalgia (28,29). We hypothesized that adherence would be low in the subgroup of FGID patients on TCAs given their stigmatization as “psychiatric medications” (6,7). However, we observed that subjects on TCAs reported a greater medication necessity along with higher scores on the NCF.…”

Section: Discussionmentioning

confidence: 99%

“…Drugs approved for use in other conditions (e.g., tricyclic antidepressants (TCAs)) often are implemented, leading to off-label use of medications with substantial side effect burdens. Psychotropic medications also carry stigmas, which may further interfere with patient acceptance of treatment regimens (6,7). These factors may lead to medication non-adherence; understanding and preemptively addressing FGID patients’ concerns with regard to pharmacotherapeutic regimens could potentially improve adherence.…”

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confidence: 99%

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Beliefs About GI Medications and Adherence to Pharmacotherapy in Functional GI Disorder Outpatients

Cassell

et al. 2015

American Journal of Gastroenterology

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OBJECTIVES Pharmacotherapy is a mainstay in functional gastrointestinal (GI) disorder (FGID) management, but little is known about patient attitudes toward medication regimens. Understanding patient concerns and adherence to pharmacotherapy is particularly important for off-label medication use (e.g., anti-depressants) in FGID. METHODS Consecutive tertiary GI outpatients completed the Beliefs About Medications questionnaire (BMQ). Subjects were categorized as FGID and structural GI disease (SGID) using clinician diagnoses and Rome criteria; GI-specific medications and doses were recorded, and adherence to medication regimens was determined by patient self-report. BMQ domains (overuse, harm, necessity, and concern) were compared between FGID and SGID, with an interest in how these beliefs affected medication adherence. Psychiatric measures (depression, anxiety, and somatization) were assessed to gauge their influence on medication beliefs. RESULTS A total of 536 subjects (mean age 54.7±0.7 years, range 22–100 years; n=406, 75.7% female) were enrolled over a 5.5-year interval: 341 (63.6%) with FGID (IBS, 64.8%; functional dyspepsia, 51.0%, ≥2 FGIDs, 38.7%) and 142 (26.5%) with SGID (IBD, 28.9%; GERD, 23.2%). PPIs (n=231, 47.8%), tricyclic antidepressants (TCAs) (n=167, 34.6%), and anxiolytics (n=122, 25.3%) were common medications prescribed. FGID and SGID were similar across all BMQ domains (P>0.05 for overuse, harm, necessity, and concern). SGID subjects had higher necessity-concern framework (NCF) scores compared with FGID subjects ( P=0.043). FGID medication adherence correlated negatively with concerns about medication harm (r=−0.24, P<0.001) and overuse (r=−0.15, P=0.001), whereas higher NCF differences predicted medication compliance (P=0.006). Medication concern and overuse scores correlated with psychiatric comorbidity among FGID subjects (P<0.03 for each). FGID patients prescribed TCAs (n=142, 41.6%) expressed a greater medication necessity (17.4±0.4 vs. 16.2±0.4, P=0.024) and found their GI regimen to be more helpful (P=0.054). FGID subjects not on TCAs expressed a greater apprehension about medication overuse (10.7±0.3 vs. 9.7±0.2, P=0.002) on the BMQ. CONCLUSIONS FGID subjects report medication necessity and concern scores comparable to patients with SGID but have negative perceptions about medications, particularly in the presence of psychiatric comorbidity; these factors may affect treatment adherence and willingness to initiate neuromodulator regimens.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Beliefs About GI Medications and Adherence to Pharmacotherapy in Functional GI Disorder Outpatients

Cassell

et al. 2015

American Journal of Gastroenterology

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“…Participants in this study also reported "secondary" non-adherence, such as the unavailability of medication at the pharmacy, as well as stigma related reasons, such as doubting the efficacy of medication, or as a result of their perception about society's negative view of psychiatric treatment. With regard to attitudes towards antidepressants, Castaldelli-Maia et al noted for example, that stigma against depression differs from stigma against the use of antidepressants, with the latter seemingly more related to associations with emotional weakness and an inability to deal with problems 21 . Reviewing associations with the diagnosis of schizophrenia in the Brazilian media, Guarniero et al, confirmed that texts from the printed media reviewed seem to still reinforce existing stigma by superficially referring to the diagnosis and by trivializing it out of context 22 .…”

Section: Discussionmentioning

confidence: 99%

“…Access to psycho-educational information included the standardized SADAG Board approved brochures on major depression, bipolar mood disorder, anxiety disorders, schizophrenia, and substance use disorders. The post-intervention questionnaire was conducted after the three-month implementation period and included items on: the RSAP implementation (Questions 1-9); post-participation adherence (Questions 10-12); as well as evaluating the RSAP (Questions [13][14][15][16][17][18][19][20][21][22].…”

Section: Addendummentioning

confidence: 99%

Communication and adherence of patients at a South African public sector specialist psychiatric out-patient clinic

Rensburg

Taljaard²,

Wilson³

2014

Arc. Clin. Psychiatr.

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Background: The impact that communication has on adherence, considering outcomes such as patient satisfaction and recall of the content of encounters with health care providers, has been extensively reported on in the literature. The South African Depression and Anxiety Group (SADAG) developed a specific communication intervention program, which was implemented in a local public sector setting. Objective: To investigate the attendance and medication adherence of patients at the specialist psychiatric outpatient clinic of the Helen Joseph Hospital in Johannesburg, before and after the pilot implementation of this program. Methods: Included quantitative and qualitative methodologies. The retrospective component included a review of participants' demographic and clinical profile and medication adherence. The prospective, qualitative component included structured pre-and post-questionnaires. Results: The typical participant was female (76%), older than 40 years (58.2%) and unemployed (74.2%). Comparing the study and control groups, the communication program resulted in a higher post-intervention booking ratio for the Study group, while the diagnostic category of participants were associated with their understanding of their medication. Discussion: Being mindful of the noted limitations of this pilot project, the SADAG program or similar communication intervention strategy, should be a standard operational procedure in local South African state sector clinics.

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“…Negative attitudes are particularly strong against the use of drugs to treat mental disorders (Jenkins and Carpenter-Song, 2009;Sorsdahl and Stein, 2010). For example, the use of antidepressants to treat depression is often perceived as a sign of emotional weakness and inability to deal with problems (Castaldelli-Maia et al, 2011).…”

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confidence: 99%

Beliefs and Attitudes Among Italian High School Students Toward People With Severe Mental Disorders

Serra

Lai

Buizza

et al. 2013

Journal of Nervous &Amp; Mental Disease

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The negative attitudes surrounding mental disorders and their treatment are a major obstacle to the correct identification and treatment of emerging psychopathologies. The purpose of this study was to investigate mental health literacy in a large and representative sample of high school students in Italy, via a booklet containing several questionnaires delivered to 1032 teenagers. The items in the questionnaires probed knowledge about mental health and illness, stigmatization, stereotypes, behaviors, opinions, and attitudes. In general, the students had a reasonable knowledge of mental disorders and were able to distinguish these from somatic disorders. However, a large portion of the students nourished some misconceptions about mental disorders and was also rather skeptical about the effectiveness of treatment or the chance of recovery for people with severe mental disorders. Nevertheless, roughly half of the students reported being willing to provide help to someone with a mental disorder when in need. Poor mental health literacy is a major barrier to seeking help and receiving effective treatment. Young people are the ideal target of raising awareness and antistigma campaigns because they are at a higher risk for developing a psychopathology.

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Perceptions of and Attitudes Toward Antidepressants

Cited by 42 publications

References 50 publications

Beliefs About GI Medications and Adherence to Pharmacotherapy in Functional GI Disorder Outpatients

Beliefs About GI Medications and Adherence to Pharmacotherapy in Functional GI Disorder Outpatients

Communication and adherence of patients at a South African public sector specialist psychiatric out-patient clinic

Beliefs and Attitudes Among Italian High School Students Toward People With Severe Mental Disorders

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