Article Figures & Data
Figures
- Figure 1.
Factors explaining antidepressant beliefs.
Tables
Characteristic Value CIRS = Cumulative Illness Rating Scale (possible scores: 0–56, higher scores indicate more severe illness); HAM-D17 = 17-item Hamilton Rating Scale for Depression (possible total scores: 0–52, higher total scores indicate more severe depression); IQR = interquartile range. Sex (female), % 57.5 Age, years, mean±SD 34.2±10.5 Race, % White 78.0 African American 11.7 Asian 2.6 American Indian or Alaskan Native 1.0 Native Hawaiian or Pacific Islander 1.6 Other or unspecified 5.1 Ethnicity (Hispanic), % 4.6 Education, years, mean±SD 15.1±3.4 Private health insurance, % 77 Number of nonpsychiatric comorbid conditions, mean ± SD 1.4±1.5 Severity of illness, CIRS score, mean ± SD 1.07 ± 0.50 Depression characteristics Symptom severity (HAM-D17 total score), mean±SD 20.7±4.0 Duration of current episode, months, median (IQR) 16 (8–34) Number of prior episodes, median (IQR) 3 (2–6) Age of onset for first episode, years, median (IQR) 20 (15–30) Axis I comorbidity, % 57.7 Prior antidepressant use, % 34.1 Depression in first-degree relative(s), % 51.1 Dependent Variable Independent Variable β P Valuea HAM-D17 = 17-item Hamilton Rating Scale for Depression. a All effects are adjusted for correlation due to clustering of patients within clinics. b Total R2 = .30. c Retained because this variable did not meet removal criterion of P =.10 in second block. d Total R2 = .13. Necessity beliefb Age .27 <.001 Sex −.06 .34 Years of education −.05 .65 Depressive symptom severity (HAM-D17 total score) .17 .03 Number of prior episodes .12 .09c Belief that symptoms will last a long time .26 .001 Belief that symptoms were caused by a chemical imbalance .22 .005 Harmfulness beliefd Age .00 .99 Sex .00 .99 Years of education .03 .69 History of antidepressant use −.17 .02 Belief that symptoms were randomly caused .21 .04 Subjective poor understanding of symptoms .19 .003
The Article in Brief
Explaining Patients' Beliefs About the Necessity and Harmfulness of Antidepressants
James E. Aikens, PhD , and colleagues
Background More than one-half of patients who are prescribed antidepressants either discontinue their medication early or take it too inconsistently to gain any medical benefit. This appears to increase the risk of relapse and recurrence of depression. To help with this problem, researchers set out to explore patients' beliefs about the necessity and harmfulness of antidepressants.
What This Study Found Patients with major depression who are younger, have never taken antidepressants, view their symptoms as mild and temporary, and are unclear about the causes of their depression are most likely to be skeptical about antidepressants.
Implications
- This group of patients might benefit from educational efforts focused on their beliefs about antidepressants, thus promoting a greater willingness to take their medication and better results in treating their depression. Because negative treatment attitudes might be based on patients' experiences, however, it might not always be appropriate to try to change their beliefs about taking medications.
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