Antidepressant awareness and stigmatizing attitudes toward depression and antidepressants, a comparison between first and sixth-year medical students

Web Survey of Turkish Pharmacy Students Comparing First and Fifth Years' Antidepressant Awareness and Stigmatizing Attitudes Regarding Depression and Anxiety

The prevalence of depression and anxiety has increased day by day. Prejudice, self-stigma, and public stigma, on the other hand, continue to prevent patients from seeking adequate treatment, particularly in traditional communities. In this web-based, cross-sectional study, both the presence of depression and anxiety, and the knowledge, attitude, and awareness of first- and fifth (final)-year pharmacy students were examined via an online survey. The aim was to demonstrate the potential impact of public information and five years of pharmacy school on knowledge, attitude, and awareness. Our study population consisted of first- and fifth-year pharmacy students enrolled in one faculty of pharmacy during the spring semester of 2022-2023. The Beck Depression Inventory and Beck Anxiety Scale were utilized to measure the presence of depression and anxiety, while the Depression and Antidepressant Awareness and Knowledge Scale (DAKAS) was applied to assess their knowledge, attitude, and awareness. Fifth-year participants (n = 101) exhibited noticeably fewer stigmatizing attitudes than first-year participants (n = 104) (p < 0.05). There was no statistically significant difference between the mean Beck Depression Inventory and Beck Anxiety scores in first- and fifth-year pharmacy students. Being in the fifth class (OR: 3.690; p = 0.025), being of female gender (OR: 4.653; p < 0.001), and having a relationship with someone who took a psychotropic (OR: 3.060; p = 0.008) were associated with a lower overall stigma score by multiple linear regression analysis. The students' awareness of antidepressants and familiarity with mental health issues at the end of their pharmacy education were higher and stigmatization behavior was lower than in first-year students. The positive attitudes at the end of their training towards depression will reduce the likelihood of future pharmacists' patients from being exposed to stigmatization, prevents the formation of an additional stress factor, and likely will improve pharmacy practices.

An investigation of knowledge and attitudes towards antidepressants: a cross-sectional survey of Jordan's six medical schools

OBJECTIVE

Depression is Jordan's most ravaging mental illness. Despite the growth of antidepressant use, only a handful of studies examine the factors affecting antidepressant knowledge among healthcare workers or medical students. Therefore, we aimed to explore the knowledge and attitudes towards antidepressants across Jordan's six medical schools.

METHODS

Using a cross-sectional design, we investigated the knowledge and attitudes towards antidepressants through the Drug Attitude Inventory and a literature-validated knowledge domain. Clinical students from Jordan's six medical schools were recruited. Differences in knowledge and attitudes scores were examined by year of study, medical school among other factors. A multivariate linear regression model was utilized to assess predictors of knowledge.

RESULTS

We included a total of 1,234 participants representing Jordan's six major schools of medicine. About 14.9% of participants had a personal history of antidepressant use while 20.5% reported family history of psychiatric disease. The majority of students demonstrated favorable attitudes towards antidepressants (74.1%). Students demonstrated an average understanding of antidepressants' mechanism of action, side effects, but not indications in special populations. Senior medical students, higher GPA, higher family income, personal history of antidepressants, and family history of psychiatric illnesses were associated with significantly higher knowledge scores (all p-values < 0.001). In addition to attitudes scores, the aforementioned were positive predictors of knowledge scores in the multivariate model.

CONCLUSION

Medical students' knowledge towards antidepressants leaves room for significant improvement. Yet, it is evident that significant differences for both attitudes and knowledge exist across medical schools which may indicate a gap in either training or teaching methodology.

Initiating Antidepressant Medication: What is the Most Important Factor?

Treatment initiation is arguably the most important step in the management of depression. It is important at this stage of treatment to establish a therapeutic partnership between physician and patient, to facilitate shared decision-making. With specific regard to pharmacotherapy, negative attitudes and beliefs about antidepressant medications are common among the general public, and these can impact on how physicians who prescribe antidepressant medication are viewed. Some of these beliefs are that antidepressants are addictive, and that they change an individual's personality. Before initiating treatment, it is important for physicians to understand the patient's attitudes towards treatment, as well as their goals for treatment, especially since the patient's goals may not be the same as the physician's. Physicians can also identify patients who may be at risk of treatment resistance-those with more severe symptoms, at risk of suicide, with higher number of lifetime depressive episodes and comorbid anxiety disorder-and to differentiate treatment resistance from overlapping comorbidities. Patients need to understand that depression results from an interaction between biological and environmental factors; the use of analogies with other diseases, such as hypertension and/or a broken leg, can help in this regard. Finally, patients can be reassured that antidepressant medication is effective, and the range of agents currently available today target multiple pathways. While monotherapy is the goal, some patients will require additional treatments to manage comorbid psychiatric conditions (e.g. anxiety) or to achieve complete remission of depression. Only through complete remission of symptoms do patients achieve a level of psychosocial functioning that is equivalent to the non-depressed population. By explaining these factors to the patient, and listening to the patient's beliefs, fears and goals, physicians can forge an effective therapeutic partnership for shared decision-making and maximise the chances of success from the time of treatment initiation.