Objective: Medication adherence in psychiatric disorders, including depression, may
be influenced by 6 self-reported dimensions: 1) high/low doctor health locus of control
(HLOC), 2) high/low internal HLOC, 3) high/low psychological reactance, 4) pharmacophilia,
5) pharmacophobia, and 6) skepticism about a specific medication. This study in Spain,
Argentina, and Venezuela included 521 outpatients with depression prescribed 920 psychiatric
medications and 851 other psychiatric outpatients prescribed 1534 medications. Methods:
Logistic regression models were completed in patients with depression and psychiatric
controls. The dependent variable was adherence for each psychiatric medication (Sidorkiewicz
Adherence Tool). The models provided adjusted odds ratios (ORs) of dichotomous independent
variables: clinical variables, and 6 self-reported dimensions. Results: ORs significant
in both diagnostic groups were: 1) pharmacophobia (OR=0.500 in depression, OR=0.599
in other patients), 2) pharmacophilia (respectively OR=1.51, OR=1.65), 3) treatment
for 1 year (respectively OR=0.731, OR=0.608), 4) geriatric age (respectively OR=2.28,
OR=3.02), and 5) skepticism about a specific medication (respectively OR=0.443, OR=0.569).
Two ORs were significant in the depression group, but not in the controls: the country
of Spain (OR=0.744), and high psychological reactance (OR=0.685). The study included
470 depression patients prescribed 510 antidepressants and 348 other patients prescribed
370 antidepressants. One OR was significant for antidepressant adherence in both groups:
high psychological reactance (respectively OR=0.597, OR=0.561). Conclusions: All clinical
studies using self-report include biases but the most important is lack of access
to patients not coming for treatment. Future studies should further explore the specificity/commonality
of these dimensions, particularly psychological reactance, in depression versus other
psychiatric disorders. (Neuropsychopharmacol Hung 2021; 23(4): 374-387).
