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Stigma and its associations with medication adherence in major depressive disorder

Jingman Shi, Yan Chen, Yingchen Jiang, Yanzhi Li, Wanxin Wang, Hao Zhao, Lan Guo, Yuhua Liao, Huimin Zhang, Caihong Gao, et al.
(2024) PSYCHIATRY RESEARCH. 331.
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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.
Keywords
Internalized stigma, Perceived stigma, Antidepressants’ social determinants, Recovery, Compliance, Treatment resistance

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MLA
Shi, Jingman, et al. “Stigma and Its Associations with Medication Adherence in Major Depressive Disorder.” PSYCHIATRY RESEARCH, vol. 331, Elsevier BV, 2024, doi:10.1016/j.psychres.2023.115664.
APA
Shi, J., Chen, Y., Jiang, Y., Li, Y., Wang, W., Zhao, H., … Lu, C. (2024). Stigma and its associations with medication adherence in major depressive disorder. PSYCHIATRY RESEARCH, 331. https://doi.org/10.1016/j.psychres.2023.115664
Chicago author-date
Shi, Jingman, Yan Chen, Yingchen Jiang, Yanzhi Li, Wanxin Wang, Hao Zhao, Lan Guo, et al. 2024. “Stigma and Its Associations with Medication Adherence in Major Depressive Disorder.” PSYCHIATRY RESEARCH 331. https://doi.org/10.1016/j.psychres.2023.115664.
Chicago author-date (all authors)
Shi, Jingman, Yan Chen, Yingchen Jiang, Yanzhi Li, Wanxin Wang, Hao Zhao, Lan Guo, Yuhua Liao, Huimin Zhang, Caihong Gao, Roger S. McIntyre, Wei Hong Zhang, Xue Han, and Ciyong Lu. 2024. “Stigma and Its Associations with Medication Adherence in Major Depressive Disorder.” PSYCHIATRY RESEARCH 331. doi:10.1016/j.psychres.2023.115664.
Vancouver
1.
Shi J, Chen Y, Jiang Y, Li Y, Wang W, Zhao H, et al. Stigma and its associations with medication adherence in major depressive disorder. PSYCHIATRY RESEARCH. 2024;331.
IEEE
[1]
J. Shi et al., “Stigma and its associations with medication adherence in major depressive disorder,” PSYCHIATRY RESEARCH, vol. 331, 2024.
@article{01HHY9M0KHHTM68HTP8E0WASNC,
  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.}},
  articleno    = {{115664}},
  author       = {{Shi, Jingman and Chen, Yan and Jiang, Yingchen and Li, Yanzhi and Wang, Wanxin and Zhao, Hao and Guo, Lan and Liao, Yuhua and Zhang, Huimin and Gao, Caihong and McIntyre, Roger S. and Zhang, Wei Hong and Han, Xue and Lu, Ciyong}},
  issn         = {{0165-1781}},
  journal      = {{PSYCHIATRY RESEARCH}},
  keywords     = {{Internalized stigma,Perceived stigma,Antidepressants’ social determinants,Recovery,Compliance,Treatment resistance}},
  language     = {{eng}},
  pages        = {{9}},
  publisher    = {{Elsevier BV}},
  title        = {{Stigma and its associations with medication adherence in major depressive disorder}},
  url          = {{http://doi.org/10.1016/j.psychres.2023.115664}},
  volume       = {{331}},
  year         = {{2024}},
}
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