Are depot antipsychotics more coercive than tablets?: The patient’s perspective
Abstract
Some clinicians consider depot antipsychotics to be stigmatising, coercive and unacceptable to patients. This cross-sectional study investigated patients' perspectives of coercion for depot and oral antipsychotics. In all, 72 participants with chronic mental illness on voluntary maintenance antipsychotic medication were interviewed for their views on oral and depot medication and experiences of coercion. The MacArthur Admission Experience (short form) was adapted to explore coercion regarding medication. Mean total coercion levels were higher for those on depot (depot: mean 4.39; oral: 2.80, P = 0.027), as were perceived coercion (2.52 vs 1.73, P = 0.041) and negative pressures subscales (1.17 vs 0.33, P = 0.009). No significant differences were found for the 'voice' subscale and affective reactions. Specifically, more participants on depot felt that people try to force them to take medication (30% vs 2%, P< 0.001). Depots were perceived as more coercive than oral antipsychotics. Greater perceived coercion may explain why some consider depots to be a more stigmatising form of treatment. Although forced medication is sometimes required, the experience of coercion should be minimised by giving patients a fair say in treatment decisions, regardless of formulation.
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- Authors
- Patel, M., de Zoysa, N., Bernadt, M., Bindman, J., & David, A.
- Affiliations
- King's College London (GB)
- Division of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK
- Corresponding author
- Patel, MX
- ORCID
- Bindman, J.
- Venue
- Journal of Psychopharmacology
- Publisher
- SAGE Publications
- Published
- 2009-03-20
- Volume
- 24
- Issue
- 10
- Pages
- 1483-1489
- ISSN
- 0269-8811 (ISSN-L)
- 1461-7285
- OpenAlex
- W2134571508
- Cited by
- 47
- References
- 23
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1 · 2021: 2 · 2020: 4 · 2019: 7 · 2018: 6 · 2017: 2 · 2016: 1 · 2014: 2 · 2013: 7 · 2012: 7
- FWCI
- 3.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Cilag
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- long-acting injectable antipsychotics, oral antipsychotics, coercion, patient perspectives, chronic mental illness, involuntary medication, stigma, treatment decision-making
- MeSH terms
- Adolescent, Adult, Coercion, Cross-Sectional Studies, Delayed-Action Preparations, Female, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Physician-Patient Relations, Surveys and Questionnaires, Schizophrenia, Social Perception, Tablets, Antipsychotic Agents, Young Adult
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