Medication treatment perceptions, concerns and expectations among depressed individuals with Type I Bipolar Disorder

JOURNAL OF AFFECTIVE DISORDERS

卷:115

Article; Proceedings Paper

Sajatovic, Martha¹  Jenkins, Janis H.²  Cassidy, Kristin A.¹  Muzina, David J.³ 

[1] Case Western Reserve Univ, Sch Med, Dept Psychiat, Cleveland, OH 44106 USA

[2] Univ Calif San Diego, San Diego, CA 92103 USA

[3] Cleveland Clin, Dept Psychiat, Cleveland, OH 44106 USA

关键词: Bipolar disorder;    Subjective experience;    Mood stabilizer;    Qualitative analysis;    Patient-centered treatment;   

DOI  :  10.1016/j.jad.2008.10.002

来源: Elsevier

【 摘 要 】

Background: Subjective experience of illness affects outcomes among populations with bipolar disorder (BD). This cross-sectional study combined qualitative and quantitative approaches to evaluate perceived treatment effects, concerns and expectations among 90 individuals with BD. Methods: Adults with Type I BD, mean age 36.6 years, 51% women, completed a semi-structured interview that was audio taped, transcribed, coded and analyzed along emergent themes. Quantitative scales measured depressive symptoms (Hamilton Depression Scale/HAM-D), psychopathology (Clinical Global Impression/CGI), and insight and treatment attitudes (Insight and Treatment Attitudes Questionnaire/ITAQ). Results: Individuals had moderate depression and psychopathology with good insight into need for treatment. Drug treatment was perceived as beneficial, by stabilizing or balancing mood (42%, N=38), decreasing anxiety/depressive symptoms (19%, N=17) and improving sleep (10%, N=9). While 39%, (N=35) of individuals denied medication concerns, nearly 29%, (N=26) feared possible long-term effects, particularly diabetes or liver/kidney damage. Media stories and advertisements contributed to medication fears. Hopes and expectations for treatment ranged from those that were symptom or functional status-based, such as desiring mood stabilization and elimination of specific symptoms (23%, N=21), to more global hopes such as being normal (20%, N=18) or cured (18%, N=16). Limitations: Limitations include relatively small sample, lack of a comparator, inclusion of only depressed individuals and those willing to discuss their illness experience. Conclusions: While individuals with BD appreciate the effects of medications, concerns regarding adverse effects and discrepancy between actual and hoped-for outcomes can be substantial. Subjective experience with medications using qualitative and quantitative methods should be explored in order to optimize treatment collaboration and outcomes. (C) 2008 Elsevier B.V. All rights reserved.

【 授权许可】

Free