Attitudes and beliefs of patients of first episode depression towards antidepressants and their adherence to treatment

Abstract

Treatment adherence is influenced by factors like illness and patient characteristics, side effects, time taken to improve and the doctor-patient relationship. One of the important patient characteristic which has been reported to influence treatment adherence is their attitudes and beliefs towards medication. 50 subjects of first episode unipolar depression (except for severe depression with psychotic symptoms), aged 18-50 years, duration of depression of more than 1 month, with no comorbid psychiatric disorders and comorbid medical illnesses were assessed twice. At first intake, antidepressant compliance questionnaire (ADCQ) was administered. Second intake was done after 3 months for assessment of treatment adherence by using the questionnaire for assessment of treatment adherence. On component-1 of ADCQ (doctor-patient relationship), 92% agreed that doctor gave sufficient time to listen to their problem, explained the causes of depression sufficiently, felt confident that antidepressants are suitable treatment of their depression. On component-2 (preserved autonomy), most (88%) subjects believed that antidepressants are difficult to stop when taken over a long period of time and can alter patient's personality. On component-3 (positive beliefs on anti-depressants), 72% of the subjects felt, fewer tablets could be taken on days one feels better. On component-4 (partner agreement), 96% of subjects reported their partner's positive attitude towards diagnosis and treatment. At the time of second assessment, majority of the subjects (88%) missed the antidepressant medication on less than 25% days in the last 3 months whereas only 4% of the subjects missed antidepressants for more than 75% of the days. Thirty eight percent of the subjects dropped out of the follow up at 3 months of first assessment. Most of the patients value the doctor-patient relationship & their partners are also supportive regarding diagnosis and treatment of depression. However, most patients have erroneous beliefs regarding antidepressants per se which in turn influence the drug compliance.