Aim: Depression is under recognized and undertreated, in spite of the availability of effective treatments. Psychological barriers to treatment can be obstacles to treatment participation and affect the course of care. We examine the impact of stigma and patients' perceptions of illness at treatment initiation on medication adherence among a mixed age sample of outpatients with major depression.
Methods: A two-stage sampling design was used to identify outpatients with SCID diagnosed Major Depression seeking outpatient mental health treatment. New admissions (N=134) who took a prescribed antidepressant medication for at least one week were administered instruments to assess perceived stigma, self-rated illness severity and patients' views of treatment. Three months later, patients were reinterviewed. Patients were classified as adherent or nonadherent based on patient self-report estimates of the number and frequency of missed doses.
Results: Among the mixed age group, medication adherence was predicted by lower perceived stigma (OR=.92, p=.05), higher self-rated illness severity (OR=1.22, p=. 05) being older than 60 years old (OR=2.91, p=. 04) and screening negative for personality pathology (OR=0.32, p=. 02).
Conclusions: Perceived stigma associated with mental illness and patients' views of the illness play important roles in undermining adherence to treatment for depression. Clinician attention to psychological barriers early in outpatient treatment may improve medication adherence, and ultimately, affect the course of illness.
Learning Objectives: 1) To identify psychological barriers to mental health treatment 2) To understand the link between barriers and treatment adherence
Keywords: Barriers to Care, Depression
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.