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Predictive Value of Self-Stigma, Insight, and Perceived Adverse Effects of Medication for the Clinical Outcomes in Patients With Depressive Disorders

Yen, Cheng-Fang MD, PhD*†; Lee, Yu MD; Tang, Tze-Chun MD; Yen, Ju-Yu MD†§; Ko, Chih-Hung MD; Chen, Cheng-Chung MD, PhD*†∥

The Journal of Nervous and Mental Disease: March 2009 - Volume 197 - Issue 3 - p 172-177
doi: 10.1097/NMD.0b013e318199fbac
Original Article
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The aims of this prospective study were to examine the predictive values of self-stigma, insight, and perceived adverse effects of medication for remission of depressive symptoms, suicidal risk, and medication adherence in patients with depressive disorders over a 1-year follow-up period. One hundred seventy-four participants who were in a state of obvious depression underwent an index interview to determine their degree of self-stigma, insight, and perceived adverse effects of medication. One year later, they were reassessed to determine the severity of their depressive symptoms, suicidal risk, and the level of the medication adherence, and their associations with the 3 possible predictors at the index interview were examined. The results of this study indicated that perceiving more severe adverse effects of medication at the index interview increased the risks of the nonremission of depressive symptoms, occurrence of suicidal ideation or attempt, and medication nonadherence in patients with depressive disorders in the 1-year period. However, the degrees of self-stigma and insight did not predict the severity of depressive symptoms, suicidal risk, or the level of the medication adherence. Based on the results of this study, we suggest that it is important for clinicians to prevent the occurrence of and to help patients manage the adverse effects of medication. We also suggest that further prospective studies are needed to examine the predictive values of self-stigma and insight for clinical outcomes and medication adherence.

*Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; †Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; ‡Department of Psychiatry, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan; §Department of Psychiatry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan; and ∥Kai-Suan Psychiatric Hospital, Kaohsiung, Taiwan.

Send reprint requests to Cheng-Chung Chen, MD, PhD, Department of Psychiatry, Kaohsiung Medical University, No. 100 Tzyou 1st Rd., Kaohsiung City, Taiwan 807. E-mail: ccchen@mail.khja.org.tw.

© 2009 Lippincott Williams & Wilkins, Inc.