Predictors of Treatment Utilization in Major Depression

Alonzo, Dana; Harkavy‐Friedman, Jill; Stanley, Bárbara; Burke, Ainsley K.; Mann, J. John; Oquendo, María A.

doi:10.1080/13811118.2011.566052

Cited by 17 publications

(10 citation statements)

References 66 publications

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“…crowding index to be correlated with mental health services utilization and these items could be used in planning mental health promotion programs in Iran. Socioeconomic factors have already been reported as one of major correlates of MHS use in literature (20, 31, 41-44). …”

Section: Discussionmentioning

confidence: 99%

“…Rate of MHS use have reported in wide range between 6.5% (in elderly) and 34.5% (in college students) during last year (20, 24-25). Subjects with mental illnesses (26-27), living in stressful conditions such as immigrants (28-29)and victims of crimes such as rape or violence reported higher rates (between 52%-72.5% in victims of rape (30-31), 37% in victims of intimate partner violence (32-33). Need for MHS in our study were similar to study in California in 2005 (34).…”

Section: Discussionmentioning

confidence: 99%

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454 – Correlates of mental health service utilization in married women in tehran 2011

Ahmadzad-Asl

Davoudi

Mohammadsadeghi

et al. 2013

European Psychiatry

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Objective: There are disparities in mental health services (MHS) utilization within and between populations and several factors are studied as its potential correlates. Identifying those correlates would help health policy makers to adjust service provision with characteristics of their community. To evaluate demographic, socioeconomic and system correlates of MHS utilization among married women from Tehran, Iran.Methods: A household survey of 615 married women residents of 22 municipal districts of Tehran selected via a cluster sampling method. All subjects were asked about health services utilization during last one and 12 months as well as need and access for MHS, demographic and socioeconomic factors. Independent correlates of MHS use were determined with logistic regression analysis.Results: Total 615 women, mean±SE age and duration of marital life of 42.6±0.9 and 22±0.8 years, respectively were selected, rate of MHS utilization during last one and 12 months were 5.2% and 10.1% respectively. 23.6% of women reported having mental illness and 19.3% and 17.9% had need for MHS and access to outpatient health services, respectively. Logistic regression models showed that need for MHS (OR:5.25, 95%CI:2.7-10.1), access to outpatient services (OR:2.17, 95%CI:1.04-4.52), smoking (OR:3.4, 95%CI:1.16-10.2) and crowding index (OR:0.69, 95%CI:0.48-0.99).Conclusions: Rate of MHS utilization in women are low considering the near to estimated rate of perceived illness. Bridging the gap between perceived illness and need for services, then providing better access to services in areas with higher crowding index and higher rates of smoking in residents should considered in any mental health promotion programs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

454 – Correlates of mental health service utilization in married women in tehran 2011

Ahmadzad-Asl

Davoudi

Mohammadsadeghi

et al. 2013

European Psychiatry

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“…In this sense, we observed that psychiatric hospitalizations and suicidal ideation were also associated to suboptimal adherence, suggesting that more severe patients are also less adherents. Alonzo et al (2011) warned about the poor utilization of treatment by suicide attempters with MD.…”

Section: Discussionmentioning

confidence: 99%

Determinants of suboptimal medication adherence in patients with a major depressive episode

et al. 2018

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Background Major Depression (MD) is often a chronic condition requiring a long‐term pharmacologic treatment. Despite the efficacy of antidepressants, the medication adherence in those affected is usually very poor. In this scenario, further research concerning drivers of suboptimal adherence is needed. We aimed to explore medication adherence in patients with a MD episode, and to identify sociodemographic, clinical (psychiatric antecedents, comorbidities, medication, pain, and medication side effects), and psychosocial factors (negative life events, childhood trauma, and attitudes to medication) related to adherence status. Method The Medication Adherence Rating Scale (MARS) was completed by 370 patients at hospital admission. Participants were divided into groups of optimal and suboptimal adherence based on the medication adherence behavior score (MARS's factor 1), and were compared with respect to the study variables. Results Twenty‐nine percent of participants (n = 107) were found to be optimally adherents to their medication (score = 4/4). Compared to optimally adherents, suboptimally adherents (71%) presented a significantly higher depression severity, more psychiatric hospitalizations, suicidal ideation, physical pain, negative medication side effects, and antecedents of emotional maltreatment. Suboptimally adherents also had less favorable attitudes toward medication and were less in a relationship than optimally adherents. Multivariate analyses showed that depression severity, suicidal ideation, and physical pain increase the probability of belonging to the suboptimal adherent group. Conclusion These results suggest a vicious circle in which more vulnerable patients are less adherent to medication, which could worsen the clinical picture maintaining, in turn, low adherence. More efforts are needed to develop interventions aiming to improve medication adherence in MD patients.

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“…In addition to the covariates used in the other regression models, time-updated measures of antidepressant medication use and psychotherapy visits were included – both as a proxy for depression severity as previous research has linked treatment utilization with depression severity. (41)…”

Section: Methodsmentioning

confidence: 99%

Examining the Relationship Between Depression and Asthma Exacerbations in a Prospective Follow-Up Study

Ahmedani

Peterson

Wells

et al. 2013

Psychosomatic Medicine

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Background While depression has been linked with asthma in numerous studies, its relationship with asthma exacerbations, including emergency room (ER) visits and oral steroid (OS) use has not been well documented. The main aim is to investigate whether comorbid depression increases exacerbations among patients with asthma. Method The study included 568 participants with asthma, who were between 18-56 years old, were taking an inhaled corticosteroid, and participated in both baseline and follow-up surveys. Surveys and medical records from a large, integrated health system were collected as part of the Adherence Feedback for Improving Respiratory Medication Use trial (ClinicalTrials.gov: NCT00459368). Number of ER visits and OS prescription fills for asthma were calculated for 12-month periods before and after the follow-up survey. Depression was measured using a standardized two-item instrument on both surveys. Negative binomial regression and modified proportional hazards models were used in the analyses. Results Among patients with asthma, those who had depression (n=187; 32.9%) were at increased risk of having an asthma-related ER visit (adjusted relative risk (aRR): 1.96, 95% confidence interval (CI): 1.02 - 3.75), but not an OS fill (aRR: 0.98; 95%CI: 0.72-1.32). Participants with depression and asthma, who also received psychiatric treatment via antidepressant medication (n=126; 22.2%) or psychotherapy (n=39; 6.9%), were more likely to have an ER visit (medication hazard ratio (HR): 2.09, 95%CI: 1.35-3.25; psychotherapy HR: 2.07, 95%CI: 1.38-3.22). Conclusion This study suggests a temporal relationship between depression and asthma-related ER visits. Research and practice must further consider the importance of these comorbid conditions.

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Predictors of Treatment Utilization in Major Depression

Cited by 17 publications

References 66 publications

454 – Correlates of mental health service utilization in married women in tehran 2011

454 – Correlates of mental health service utilization in married women in tehran 2011

Determinants of suboptimal medication adherence in patients with a major depressive episode

Examining the Relationship Between Depression and Asthma Exacerbations in a Prospective Follow-Up Study

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