Effects of Caregivers' Perceived Stigma and Causal Beliefs on Patients' Adherence to Antidepressant Treatment
Abstract
OBJECTIVE: Nonadherence to prescribed medications is a significant problem in the treatment of mood disorders. Previously proposed adherence models have not been sufficiently accurate in identifying patients who do not adhere to treatment. This study evaluated the importance of the social context in adherence by using a prospective, longitudinal analysis. Specifically, this study evaluated the effects of caregivers' causal beliefs about depression and their perceptions of stigma on three-month treatment adherence among patients with depression. METHODS: Fifty patients with major depressive disorder and their primary caregivers were identified at a psychiatric hospital's outpatient clinic. Attributions for the causes of depression (either cognitive and attitudinal or medical and biological) and perceived stigma were assessed among caregivers at baseline, and patients' adherence was evaluated three-months after treatment began. RESULTS: Data were available for 47 patients at follow-up. Caregivers' attribution of depression to cognitive and attitudinal problems significantly predicted patients' decreased adherence. However, the degree of patients' adherence was not predicted by caregivers' attributions to medical and biological causes and caregivers' perceived stigma. CONCLUSIONS: The findings stress the importance of patients' social environment in determining treatment adherence and the necessity of educating caregivers about the impact that their causal attributions have on patients' behavior. Involving caregivers in treatment may improve their attitude toward patients with depression and, in doing so, enhance patients' adherence and outcome.
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Psychiatric patients may attribute antipsychotic medication non-adherence to alterations in cognitive and attitudinal functioning and therefore be unwilling to use the medication in three studies.
“In three studies, psychiatric patients may also attribute to antipsychotic medication non-adherence due to the alterations in cognitive and attitudinal functioning and therefore be unwilling to use the medication [29, 37, 38].”
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 [38]
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- Authors
- Sher, I., McGinn, L., Sirey, J. A., & Meyers, B.
- Affiliations
- Yeshiva University (US)
- Venue
- Psychiatric Services
- Published
- 2005-05
- Volume
- 56
- Issue
- 5
- Pages
- 564-569
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W2099567712
- Cited by
- 50
- References
- 36
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 3 · 2018: 4 · 2016: 3 · 2015: 3 · 2014: 3 · 2013: 4 · 2012: 3
- FWCI
- 2.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (K23MH066381)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
- Keywords
- medication adherence, antidepressants, major depressive disorder, caregiver stigma, causal beliefs, attribution theory, caregiver involvement, mood disorders
- MeSH terms
- Adult, Aged, Antidepressive Agents, Female, Humans, Male, Middle Aged, New York, Patient Compliance, Prejudice, Caregivers, Mood Disorders
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