Attitudes and beliefs of patients with chronic depression toward antidepressants and depression

Background Many patients have erroneous views with regard to depression and its management, and it was noted that these attitudes and beliefs significantly affected their adherence rates. Objectives The primary aim of this study was to determine the attitudes and beliefs of patients with depression toward depression and antidepressants. A secondary aim was to assess the influence of ethnicity on patients’ attitudes and beliefs. Patients and methods The study involved patients with chronic depression being followed up at an outpatient clinic at a government-run hospital in Malaysia. Patients’ attitudes and beliefs were assessed using the Antidepressant Compliance Questionnaire. Results A total of 104 patients of Malay, Chinese, and Indian ethnic groups met the selection criteria. Chinese patients had significantly negative attitudes and beliefs toward depression and antidepressants compared to Malays and Indians (b=-8.96, t103=-3.22; P<0.05). Component analysis revealed that 59% of patients believed that antidepressants can cause a person to have less control over their thoughts and feelings, while 67% believed that antidepressants could alter one’s personality; 60% believed it was okay to take fewer tablets on days when they felt better, while 66% believed that antidepressants helped solve their emotional problems and helped them worry less. Conclusion Patients had an overall positive view as to the benefits of antidepressants, but the majority had incorrect views as to the acceptable dosing of antidepressants and had concerns about the safety of the medication. Assessing patients’ attitudes and beliefs, as well as the impact of their respective cultures, can be used in tailoring psychoeducation sessions accordingly.

[1]  K. Demyttenaere,et al.  Depressive and bipolar disorders: patients' attitudes and beliefs towards depression and antidepressants , 2005, Psychological Medicine.

[2]  A. Reid.  Questionnaires , 1988, How to Enhance Your Research.

[3]  W. Sabry,et al.  Role of Islam in the management of Psychiatric disorders , 2013, Indian journal of psychiatry.

[4]  John Weinman,et al.  Medicine in a multi-cultural society: the effect of cultural background on beliefs about medications. , 2004, Social science & medicine.

[5]  S. Sulaiman,et al.  Mental health literacy towards depression among non-medical students at a Malaysian university. , 2010, Mental health in family medicine.

[6]  D. Ford,et al.  Ethnicity and preferences for depression treatment. , 2007, General hospital psychiatry.

[7]  Priscilla Killian,et al.  Health beliefs about depression among African American women. , 2008, Perspectives in psychiatric care.

[8]  T. Higuchi,et al.  The effect of an educational leaflet on depressive patients' attitudes toward treatment , 2010, Psychiatry Research.

[9]  C. Hoven,et al.  Use of complementary and alternative medicine among women with depression: results of a national survey. , 2007, Psychiatric services.

[10]  H. Burger,et al.  A cluster randomized trial comparing two interventions to improve treatment of major depression in primary care , 2005, Psychological Medicine.

[11]  Claudio Violato,et al.  Knowledge of and attitudes towards depression and adherence to treatment: the Antidepressant Adherence Scale (AAS). , 2010, Journal of affective disorders.

[12]  Eun-Seok Cha,et al.  Translation of scales in cross-cultural research: issues and techniques. , 2007, Journal of advanced nursing.

[13]  S. Francis,et al.  Building concordant relationships with patients starting antidepressant medication. , 2004, Patient education and counseling.

[14]  E. Vermeire,et al.  Patient adherence to treatment: three decades of research. A comprehensive review , 2001, Journal of clinical pharmacy and therapeutics.

[15]  E. Isometsä,et al.  Treatment attitudes and adherence of psychiatric patients with major depressive disorder: a five-year prospective study. , 2010, Journal of affective disorders.

[16]  O. Bodlund,et al.  Patients' beliefs about the cause of their depression. , 2010, Journal of affective disorders.

[17]  R. Snaith,et al.  Grade Scores of the Montgomery—Åsberg Depression and the Clinical Anxiety Scales , 1986, British Journal of Psychiatry.

[18]  J. Weinman,et al.  Patients' beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. , 1999, Journal of psychosomatic research.

[19]  Zuraida Nz,et al.  Religiosity and Suicide Ideation in Clinically Depressed Patients , 2007 .

[20]  S. Grover,et al.  Attitudes and beliefs of patients of first episode depression towards antidepressants and their adherence to treatment , 2009, Social Psychiatry and Psychiatric Epidemiology.

[21]  Jing Jin,et al.  Factors affecting therapeutic compliance: A review from the patient’s perspective , 2008, Therapeutics and clinical risk management.

[22]  M. Åsberg,et al.  A New Depression Scale Designed to be Sensitive to Change , 1979, British Journal of Psychiatry.

[23]  H. Christensen,et al.  Belief in the harmfulness of antidepressants: results from a national survey of the Australian public. , 2005, Journal of affective disorders.

[24]  Jan Scott.  Using Health Belief Models to Understand the Efficacy-Effectiveness Gap for Mood Stabilizer Treatments , 2003, Neuropsychobiology.

[25]  Klaas van der Meer,et al.  Health beliefs and perceived need for mental health care of anxiety and depression--the patients' perspective explored. , 2008, Clinical psychology review.

[26]  B. Svarstad,et al.  Effects of physician communication style on client medication beliefs and adherence with antidepressant treatment. , 2000, Patient education and counseling.

[27]  Anthony F Jorm,et al.  Community beliefs about treatments and outcomes of mental disorders: a mental health literacy survey in a rural area of Maharashtra, India. , 2009, Public health.

[28]  S. A. Jacob,et al.  Health-Related Quality of Life of Patients with Chronic Depression in Malaysia , 2014 .

[29]  K. Demyttenaere,et al.  Development of an antidepressant compliance questionnaire , 2004, Acta psychiatrica Scandinavica.

[30]  H. Matschinger,et al.  Public attitude towards psychiatric treatment , 1996, Acta psychiatrica Scandinavica.

[31]  Jung-Der Wang,et al.  A longitudinal study of the predictors of quality of life in patients with major depressive disorder utilizing a linear mixed effect model , 2012, Psychiatry Research.

[32]  Feryad A. Hussain,et al.  Depression in South Asian women: Asian women's beliefs on causes and cures , 2002 .

[33]  R G Priest,et al.  Lay people's attitudes to treatment of depression: results of opinion poll for Defeat Depression Campaign just before its launch , 1996, BMJ.

[34]  L. Rubenstein,et al.  The Acceptability of Treatment for Depression Among African-American, Hispanic, and White Primary Care Patients , 2003, Medical care.

[35]  A. Furnham,et al.  Public Knowledge and Beliefs About Depression Among Urban and Rural Malays in Malaysia , 2010, The International journal of social psychiatry.

[36]  C. Reynolds,et al.  Attitudes and beliefs about mental health among African American older adults suffering from depression. , 2010, Journal of aging studies.

[37]  V. Lehtinen,et al.  Psychiatric morbidity among frequent attender patients in primary care. , 1995, General hospital psychiatry.

[38]  Howard Leventhal,et al.  Behavioral theories and the problem of compliance , 1987 .

[39]  W. Rössler,et al.  Patients' attitudes toward antidepressants. , 2003, Psychiatric services.

[40]  M. Thase,et al.  Primary care patients' personal illness models for depression: a preliminary investigation. , 2001, Family practice.

[41]  D. Chiriboga,et al.  Attitudes toward mental health services: Age-group differences in Korean American adults , 2009, Aging & mental health.