Attitudes And Beliefs About Disease, Treatment And Antidepressants Among Chinese Elderly People With Depressive Disorder

Background:Large amount of evidence has approved that elderly people with depressive disorder have misconceptions and negative attitudes towards depression, its treatment and antidepressants, which in turn leads to non-adherence to medicine and even poor clinical outcomes. No study has been found in exploring how Chinese people with geriatric depression view on their depression and what’s the attitudes and beliefs about the treatment and antidepressants.Objectives:(1) To describe the attitudes and beliefs about depression, its treatment and antidepressants among Chinese elderly people with depressive disorder.(2) To explore the patients’sociodemographic and illness characteristics that may have potential influence on their attitudes towards depression and treatment, and beliefs about antidepressants.Methods:Both questionnaire and in-depth interview were utilized in this study. Consecutively150inpatients and outpatients with geriatric depression were recruited from a psychiatric hospital in Beijing. Attitudes towards Depression and its Treatment (ATDT) developed by Gabriel and Beliefs about Medicine Questionnaire-Specific (BMQ-S) devolped by Home were used to collect data. While, purposive sampling was used to recruit20elderly patients to participate into the interview.Results:(1) Concerning attitudes toward depression and treatment, the mean scores of the four components of ATDT ranking from agree to disagree were acceptance of depression and treatment (2.00±0.39), negative attitudes toward depression and antidepressants (3.03±0.48), preference for psychotherapy (3.10±0.79) and perceived stigma (3.46±0.47). The mean scores of necessity and concern on antidepressants were (3.41±0.74) and (3.00±0.70), respectively.(2) Some themes were extracted from the qualitative data. Difficulity in recognizing depression, not being able to control the cause of disease by themselves, stigma to depression were the attitudes towards disease of the patients. Attitudes towards treatment included doubts on whether seeking treatmet and diversity of therapeutic methods. Patients’ beliefs about antidepressants included necessity of antidepressants, concerns of antidepressants and discontinuance to antidepressants one day.(3) Univariate analysis indicated that educational level (F=3.910, P<0.05), occupation before retirement (Χ2=12.730, P<0.05), family income per month (F=3.702, P<0.05) were the influential factors for acceptance of depression and treatment. Martial status was the only influential factor for negative attitudes towards depression and antidepressants (t=5.295, P<0.05). Educational level (Χ2=7.907, P<0.05) and whether seeking for mental health care when first episode of depression (t=-2.571, P<0.05) had significantly relationships with preference for psychotherapy. What’s more, number of relapse of depression had been proved to the influential factor in perceived stigma of depression (F=3.956, P<0.05). As for beliefs about antidepressants, patients with different age (Z=-3.780, P<0.01) and nationality (t=-2.491, P<0.05) perceived significantly different scores on necessity of medicine, while nationaliy (t=2.285, P<0.05), patients with different marital status (F=5.225, P<0.05) and family income per month (F=5.836, P<0.05) showed diversity in concerns on antidepressants.Conclusion:Although elderly people with depressive disorder recuited from the psychiatric hospital had positive attitudes toward depression and treatment in this study, there were still some misunderstandings with depression and treatment, such as causes of the disease. Patients acknowledged the effect of the medicine, while expressing big concerns and desire to stop taking antidepressants some day later. In addition, few sociodemographic and clinical characteristics referred in this study influenced their attitudes and beliefs significantly, which suggested more modified factors should be involved in further study.