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Shi J, Chen Y, Jiang Y, Li Y, Wang W, Zhao H, Guo L, Liao Y, Zhang H, Gao C, McIntyre RS, Zhang WH, Han X, Lu C. Stigma and its associations with medication adherence in major depressive disorder. Psychiatry Res 2024; 331:115664. [PMID: 38070363 DOI: 10.1016/j.psychres.2023.115664] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/03/2023] [Accepted: 12/04/2023] [Indexed: 01/02/2024]
Abstract
This study sought to evaluate internalized stigma (IS) and perceived stigma (PS), in persons (n = 522) living with major depressive disorder (MDD), with a view to analyzing the association of IS and PS with medication adherence in a cohort of participants with MDD in China. Perceived stigma is the awareness of societal negative views and attitudes towards depression, and IS is applying others' attitudes to oneself, both measured by the Depression Stigma Scale (DSS). Medication adherence was assessed using the Medication Adherence Rating Scale (MARS). We observed that 76.0 % of participants reported IS and 84.5 % reported PS. Factors associated with increased IS included older age, marital status, disease history, and a higher baseline Patient Health Questionnaire-9 (PHQ-9). Higher education level, family income, and scores on the Connor-Davidson Resilience Scale (CD-RISC) were associated with lower levels of IS. Higher education levels, Childhood Trauma Questionnaire (CTQ) scores, and living with others were also associated with higher PS, while engagement in exercise and higher number of prior episodes were associated with lower PS. IS had a negative association with medication adherence, whereas PS did not significantly associate with adherence. In conclusion, a testable hypothesis is derived from our data that strategies targeting IS amongst persons with MDD may improve overall rates of adherence to antidepressant treatment, a necessary prelude to improving recovery.
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Affiliation(s)
- Jingman Shi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China
| | - Yan Chen
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, No.7, Huaming Road, Shenzhen 518054, PR China
| | - Yingchen Jiang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China
| | - Yanzhi Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China
| | - Hao Zhao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China
| | - Yuhua Liao
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, No.7, Huaming Road, Shenzhen 518054, PR China
| | - Huimin Zhang
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, No.7, Huaming Road, Shenzhen 518054, PR China
| | - Caihong Gao
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, No.7, Huaming Road, Shenzhen 518054, PR China
| | - Roger S McIntyre
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Wei-Hong Zhang
- International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; School of Public Health, Université libre de Bruxelles (ULB), Bruxelles, Belgium
| | - Xue Han
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, No.7, Huaming Road, Shenzhen 518054, PR China.
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China.
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