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Patterns, predictors, and patient-reported reasons for antidepressant discontinuation in the WHO World Mental Health Surveys

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dc.contributor.author Kazdin, A.E.
dc.contributor.author Harris, M.G.
dc.contributor.author Hwang, I.
dc.contributor.author Sampson, N.A.
dc.contributor.author Stein, D.J.
dc.contributor.author Viana, M.C.
dc.contributor.author Vigo, D.V.
dc.contributor.author Wu, C.-S.
dc.contributor.author Aguilar-Gaxiola, S.
dc.contributor.author Alonso, J.
dc.contributor.author Benjet, C.
dc.contributor.author Bruffaerts, R.
dc.contributor.author Caldas-Almeida, J.M.
dc.contributor.author Cardoso, G.
dc.contributor.author Caselani, E.
dc.contributor.author Chardoul, S.
dc.contributor.author Cía, A.
dc.contributor.author De Jonge, P.
dc.contributor.author Gureje, O.
dc.contributor.author Haro, J.M.
dc.contributor.author Karam, E.G.
dc.contributor.author Kovess-Masfety, V.
dc.contributor.author Navarro-Mateu, F.
dc.contributor.author Piazza Ferrand, Marina Julia
dc.contributor.author Posada-Villa, J.
dc.contributor.author Scott, K.M.
dc.contributor.author Stagnaro, J.C.
dc.contributor.author Ten Have, M.
dc.contributor.author Torres, Y.
dc.contributor.author Vladescu, C.
dc.contributor.author Kessler, R.C.
dc.date.accessioned 2023-10-12T15:30:08Z
dc.date.available 2023-10-12T15:30:08Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/14290
dc.description.abstract Background Despite their documented efficacy, substantial proportions of patients discontinue antidepressant medication (ADM) without a doctor's recommendation. The current report integrates data on patient-reported reasons into an investigation of patterns and predictors of ADM discontinuation. Methods Face-to-face interviews with community samples from 13 countries (n = 30 697) in the World Mental Health (WMH) Surveys included n = 1890 respondents who used ADMs within the past 12 months. Results 10.9% of 12-month ADM users reported discontinuation-based on recommendation of the prescriber while 15.7% discontinued in the absence of prescriber recommendation. The main patient-reported reason for discontinuation was feeling better (46.6%), which was reported by a higher proportion of patients who discontinued within the first 2 weeks of treatment than later. Perceived ineffectiveness (18.5%), predisposing factors (e.g. fear of dependence) (20.0%), and enabling factors (e.g. inability to afford treatment cost) (5.0%) were much less commonly reported reasons. Discontinuation in the absence of prescriber recommendation was associated with low country income level, being employed, and having above average personal income. Age, prior history of psychotropic medication use, and being prescribed treatment from a psychiatrist rather than from a general medical practitioner, in comparison, were associated with a lower probability of this type of discontinuation. However, these predictors varied substantially depending on patient-reported reasons for discontinuation. Conclusion Dropping out early is not necessarily negative with almost half of individuals noting they felt better. The study underscores the diverse reasons given for dropping out and the need to evaluate how and whether dropping out influences short- or long-term functioning. en_US
dc.language.iso eng
dc.publisher Cambridge University Press
dc.relation.ispartofseries Psychological Medicine
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Antidepressants en_US
dc.subject Major depressive disorder en_US
dc.subject Medication discontinuation en_US
dc.subject.mesh Antidepresivos
dc.subject.mesh Trastorno Depresivo Mayor
dc.subject.mesh Medicación Preanestésica
dc.title Patterns, predictors, and patient-reported reasons for antidepressant discontinuation in the WHO World Mental Health Surveys en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1017/S0033291723002507
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#5.01.00
dc.relation.issn 1469-8978


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