Volume 26, Number 2 (2/2015)
Original Article <page. 35-42 >

The Factors Associated with Antidepressant Adherence in Outpatients with Depressive Disorder

Duk-Soo Moon, MD, PhD1;Seung-Min An, MD2;Kyoung-Hoon Kim, PhD3;Young-Jong Kim, MD2;Sang-Min Lee, MD, PhD4; and Jong-Woo Paik, MD, PhD2;

1;Department of Psychiatry, Seoul Metropolitan Children's Hospital, Seoul, 2;Department of Psychiatry, Kyung Hee University School of Medicine, Seoul, 3;Health Insurance Review & Assessment Service, Seoul, 4;Department of Psychiatry, Konyang University College of Medicine, Konyang University Hospital, Daejeon, Korea

Objective : Although clinical guidelines recommend that antidepressant treatment should be continued for at least 4 to 9 months, naturalistic studies show that the average length of treatment is shorter than 6 months and that dropout rates are high. But factors leading patients to discontinuation of therapy are not well understood yet. In this study, we investigated factors associated with adherence to antidepressant in Korean patients with depressive disorder.

Methods : Patients who were diagnosed as depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders-4th edition criteria and took prescribed antidepressants were included in this study. Medical records of 194 patients were reviewed retrospectively. To find adherence to antidepressant treatment, we calculated Medication Possession Ratio at 2 wks, 4 wks, 8 wks, 12 wks, 24 wks after their 1st visit. Patient-related factors, illness-related factors including measurement scales (Beck Depression Inventory, Patient Health Questionnare-15, Global Assessment of Recent Stress Scale scores), and treatment-related factors were compared between adherent group and non-adherent group using chi-square test or student t-test. Multivariate logistic regression was used to predict factors associated with adherence to antidepressant treatment.

Results : Analyzing data of 194 patients, 106 patients (54.6%), and 82 patients (42.3%) were adherent group at 12 wks and 24 wks, respectively. In patient-related factors, old age and low education periods were significantly associated with adherent group. In illness-related factors and treatment-related factors, none of the factors showed a significant difference between groups. In multivariate logistic regression, old age was significantly associated with sustained adherence at 12 wks.

Conclusion : We found some factors associated with adherence to antidepressant treatment. Old age was associated with sustained adherence to antidepressant. To enhance adherence to antidepressant, our findings suggest that outpatient education program is needed. And social policy is also essential to reduce stigma in psychiatric department especially among young patients.

This Article

Key words : Depression;Antidepressant;Adherence.