Factors Associated With Antidepressant Medication Adherence and Adherence-Enhancement Programmes: A Systematic Literature Review.

Factors associated with antidepressant medication adherence and adherence-enhancement programmes: a systematic literature review.

Filed under: Depression Treatment

Ment Health Fam Med. 2011 Dec; 8(4): 255-71
van Servellen G, Heise BA, Ellis R

Medication adherence is critical to the efficacy of available treatment for depression in primary care settings. This review identifies factors associated with adherence and what is known about the effectiveness of adherence-enhancement programmes. A comprehensive systematic review of English language publications from January 2002 to October 2011 was conducted using the following databases: PUBMED/MEDLINE, PsycINFO and the Cochrane database. Twenty-one studies met the inclusion criteria for adherence-enhancement evaluations. Eleven of the studies evaluated demonstrated significantly positive effects on adherence; the remaining 10 reported mixed or no effects. Similar to previous literature reviews, factors shown to be associated with adherence were multifactorial and in this analysis were grouped as patient, condition and comorbidities, therapy or treatment, patient-provider relationship and healthcare system level. Adherence improved most notably in studies that included sustainable system and patient-targeted changes. Evaluating adherence-enhancement interventions is key to promoting successful approaches; however, a number of gaps exist between intervention and implementation: (1) the cost in resources and time to implement and sustain these programmes is unknown, (2) specific details about which subgroups of patients are best helped with such programmes is not clear, and (3) what specific processes or content are critical to programme success is still to be identified. There are sufficient data supporting the substantial need for planning and implementing adherence interventions despite reported mixed results. Primary care providers are often positioned to impact patients’ adherence; however, practice constraints can limit their implementation.
HubMed – depression


Attention-deficit hyperactive disorder presenting with school truancy in an adolescent: a case report.

Filed under: Depression Treatment

Ment Health Fam Med. 2011 Dec; 8(4): 249-54
Muhammad NA, Wan Ismail WS, Tan CE, Jaffar A, Sharip S, Omar K

Attention-deficit hyperactive disorder (ADHD) is a psychiatric illness commonly diagnosed during the early years of childhood. In many adolescents with undiagnosed ADHD, presentation may not be entirely similar to that in younger children. These adolescents pose significant challenges to parents and teachers coping with their disability. Often adolescents with behavioural problems are brought to medical attention as a last resort. This case describes an adolescent who presented to a primary care clinic with school truancy. He was initially treated for depression with oppositional defiant disorder and sibling rivalry. Only following a careful detailed history and further investigations was the diagnosis of ADHD made. He showed a positive improvement with the use of methylphenidate for his ADHD and escitalopram for his depression. The success of his management was further supported by the use of behavioural therapy and parenting interventions. There is a need to increase public awareness of ADHD, especially among parents and teachers so that early intervention can be instituted in these children.
HubMed – depression


Prevalence of depression in tuberculosis patients in comparison with non-tuberculosis family contacts visiting the DOTS clinic in a Nigerian tertiary care hospital and its correlation with disease pattern.

Filed under: Depression Treatment

Ment Health Fam Med. 2011 Dec; 8(4): 235-41
Ige OM, Lasebikan VO

Background Individuals with chronic diseases such as tuberculosis often have comorbid de-pression that requires frequent hospitalisations. This poses great challenges to the care of such patients.Objective This study aimed at determining the prevalence of depression in tuberculosis patients in comparison with non-tuberculosis controls, and its correlation with disease pattern.Method Eighty-eight patients with tuberculosis and 81 family members visiting the DOTS Centre at University College Hospital Ibadan Centre were screened for depression. Severity of depression was assessed using the Hamilton Depression Scale and was compared with severity of pulmonary tuberculosis.Results The prevalence of depression was 45.5% among patients and 13.4% among family members. Depression was more prevalent among patients that were elderly (P = 0.001), with extensive disease (P = 0.01), of long duration (P = 0.03), those with category 2 tuberculosis (P = 0.003), those from a nuclear family (P = 0.01) and patients that were unmarried (P = 0.02).Conclusion The impact of chronic diseases such as tuberculosis extends beyond physical impairment. It includes behavioural consequences, in this instance depression, for both the patient and the primary care givers. Thus, the care of patients with tuberculosis should be comprehensive and include consultative-liaison psychiatric care.
HubMed – depression


Anxiety + Depression: Effective Treatment of the Big Two Co-Occurring Disorders

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Depression : Biology, Psychodynamics, and Treatment (2012, Paperback)
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Depression: Causes and Treatment
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