Stigma as a Barrier to Recovery: Perceived Stigma and Patient-Rated Severity of Illness as Predictors of Antidepressant Drug Adherence

Sirey, Jo Anne; Bruce, Martha L.; Alexopoulos, George S.; Perlick, Deborah A.; Friedman, Steven J.; Meyers, Barnett S.

doi:10.1176/appi.ps.52.12.1615

Cited by 796Mental Health Treatment and AccessMedication Adherence and ComplianceTreatment of Major Depression

Stigma as a Barrier to Recovery: Perceived Stigma and Patient-Rated Severity of Illness as Predictors of Antidepressant Drug Adherence

Sirey, Jo Anne, Bruce, Martha L., Alexopoulos, George S., Perlick, Deborah A., Friedman, Steven J., Meyers, Barnett S.·2001·Psychiatric Services

DOI 10.1176/appi.ps.52.12.1615

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Abstract

OBJECTIVE: Major depression is undertreated despite the availability of effective treatments. Psychological barriers to treatment, such as perceived stigma and minimization of the need for care, may be important obstacles to adherence to the pharmacologic treatment of major depression. The authors examined the impact of barriers that were present at the initiation of antidepressant drug therapy on medication adherence in a mixed-age sample of outpatients with major depression. METHODS: A two-stage sampling design was used to identify adults with a diagnosis of major depressive disorder, as determined by the Structured Clinical Interview for Diagnosis, who sought mental health treatment at outpatient clinics. Additional instruments were administered to 134 newly admitted adults who had been taking a prescribed antidepressant medication for at least a week to assess perceived stigma, self-rated severity of illness, and views about treatment. The patients were reinterviewed three months later and were classified as adherent or nonadherent on the basis of self-reported estimates of the number and frequency of missed doses. RESULTS: Medication adherence was associated with lower perceived stigma, higher self-rated severity of illness, age over 60 years, and absence of personality pathology. No other characteristics of treatment or illness were significantly related to medication adherence. CONCLUSIONS: Perceived stigma associated with mental illness and individuals' views about the illness play an important role in adherence to treatment for depression. Clinicians' attention to psychological barriers early in treatment may improve medication adherence and ultimately affect the course of illness.

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Patients who perceived that the treatment had no effect on their illness were more likely to be non-adherent to their medication in two studies.
“Similarly, in two studies, those patients who perceived that the treatment had no effect on their illness were more likely to be non-adherent to their medication [26, 40].”
From Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: A systematic review and meta-analysis (2020) · cites this paper as [26]

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Perceived Stigma and Patient-Rated Severity of Illness as Predictors of Antidepressant Drug Adherence
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Authors: Sirey, J. A., Bruce, M. L., Alexopoulos, G. S., Perlick, D. A., Friedman, S. J., & Meyers, B. S.
Affiliations: NewYork–Presbyterian Hospital (US)
ORCID: Sirey, Jo Anne
Bruce, Martha L.
Alexopoulos, George S.
Perlick, Deborah A.
Meyers, Barnett S.
Venue: Psychiatric Services
Publisher: American Psychiatric Association Publishing
Published: 2001-12
Volume: 52
Issue: 12
Pages: 1615-1620
ISSN: 0022-1597 (ISSN-L)
1075-2730
1557-9700
DOI: 10.1176/appi.ps.52.12.1615
OpenAlex: W2125103779
Cited by: 796
References: 24
Citations by year: 2026: 12 · 2025: 16 · 2024: 16 · 2023: 49 · 2022: 21 · 2021: 28 · 2020: 38 · 2019: 23 · 2018: 26 · 2017: 70 · 2016: 45 · 2015: 37 · 2014: 38 · 2013: 51 · 2012: 43
FWCI: 18.98
Type: journal article
Language: en
Open access: closed
Locations: Psychiatric Services (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5r24mh053816-05)
National Institute of Mental Health (MH53816)
Topics: Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords: perceived stigma, medication adherence, antidepressants, major depressive disorder, undertreatment of depression, personality pathology, age over 60, outpatients
MeSH terms: Adaptation, Psychological, Adult, Aged, Antidepressive Agents, Attitude to Health, Mental Disorders, Female, Humans, Male, Middle Aged, Patient Compliance, Stereotyping, Recovery of Function

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Stigma as a Barrier to Recovery: Perceived Stigma and Patient-Rated Severity of Illness as Predictors of Antidepressant Drug Adherence

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