Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-24T14:57:52.346Z Has data issue: false hasContentIssue false
  • English
  • Français

Beliefs about antidepressants among persons aged 70 years and older in treatment after a suicide attempt

Published online by Cambridge University Press:  02 March 2015

Eva Lesén ,
Stefan Wiktorsson ,
Anders Carlsten ,
Margda Waern  and
Tove Hedenrud
Eva Lesén
Affiliation:
Nordic Health Economics AB, Gothenburg, Sweden
Stefan Wiktorsson
Affiliation:
Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Anders Carlsten
Affiliation:
Medical Products Agency, Uppsala, Sweden
Margda Waern
Affiliation:
Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Tove Hedenrud*
Affiliation:
Dept. of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
*
Correspondence should be addressed to: Tove Hedenrud, Dept. of Public Health and Community Medicine, P.O. Box 453, 405 30 Gothenburg, Sweden. Phone: +46-31-786 6855. Email: tove.hedenrud@gu.se.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

The use of antidepressants is associated with decreased suicide risk in late life, and these drugs are often prescribed after a suicide attempt. Yet little is known about attitudes to antidepressants in older persons with suicidal behavior. The aim of this study was to assess beliefs about antidepressant medicines in older persons in treatment one year after a suicide attempt.

Methods:

Forty-four individuals aged 70 years and older, who were treated in emergency wards at five hospitals in western Sweden in connection with a suicide attempt, were interviewed at index attempt and one year later. Beliefs about medicines questionnaire (BMQ) specific for antidepressants were analyzed one year after index attempt, in relation to sociodemographic variables, medication use, psychiatric evaluation, and personality traits.

Results:

The majority of participants perceived the necessity of their antidepressant medicine to outweigh their concerns. Lower perceived necessity of antidepressants was observed in those who were not on antidepressants at the time of the attempt as well as those with no prior history of suicide attempt before the index attempt. Individuals reporting hopelessness at follow-up had a higher perceived concern about using medication.

Conclusions:

Beliefs about antidepressants tended to be more positive than negative in older persons taking these drugs in the aftermath of a suicide attempt. Further studies are called for, and should include objective measures of medication adherence.

Keywords

beliefs about antidepressantssuicide attemptolder persons
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 11 , November 2015 , pp. 1795 - 1803
Copyright
Copyright © International Psychogeriatric Association 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aikens, J. E. and Klinkman, M. S. (2012). Changes in patients’ beliefs about their antidepressant during the acute phase of depression treatment. General Hospital Psychiatry, 34, 221–226. doi:10.1016/j.genhosppsych.2012.01.004.CrossRefGoogle ScholarPubMed
Aikens, J. E., Nease, D. E. Jr. and Klinkman, M. S. (2008). Explaining patients’ beliefs about the necessity and harmfulness of antidepressants. Annals of Family Medicine, 6, 23–29. doi:10.1370/afm.759.CrossRefGoogle ScholarPubMed
Asberg, M., Montgomery, S. A., Perris, C., Schalling, D. and Sedvall, G. (1978). A comprehensive psychopathological rating scale. Acta Psychiatrica Scandinavica. 57, 5–27. doi: 10.1111/j.1600-0447.1978.tb02357.x. CrossRefGoogle Scholar
Barbui, C., Esposito, E. and Cipriani, A. (2009). Selective serotonin reuptake inhibitors and risk of suicide: a systematic review of observational studies. CMAJ: Canadian Medical Association Journal, 180, 291–297. doi:10.1503/cmaj.081514.CrossRefGoogle ScholarPubMed
Brown, C. et al. (2005). Beliefs about antidepressant medications in primary care patients: relationship to self-reported adherence. Medical Care, 43, 1203–1207.CrossRefGoogle ScholarPubMed
Cohen, N. L., Ross, E. C., Bagby, R. M., Farvolden, P. and Kennedy, S. H. (2004). The 5-factor model of personality and antidepressant medication compliance. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 49, 106–113.CrossRefGoogle ScholarPubMed
Conwell, Y., Duberstein, P. R. and Caine, E. D. (2002). Risk factors for suicide in later life. Biological Psychiatry, 52, 193–204.CrossRefGoogle ScholarPubMed
Eysenck, H. J. and Eysenck, S. G. G. (1964). Manual of the Eysenck Personality Inventory. London: University of London Press.Google Scholar
Fawzi, W. et al. (2012). Beliefs about medications predict adherence to antidepressants in older adults. International Psychogeriatrics, 24, 159–169. doi:10.1017/S1041610211001049.CrossRefGoogle ScholarPubMed
Frances, A. and American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV: Prepared by the Task Force on DSM-IV. Washington, DC: American Psychiatric Assoc. Google Scholar
Gibbons, R. D. et al. (2007). Relationship between antidepressants and suicide attempts: an analysis of the Veterans Health Administration data sets. American Journal of Psychiatry, 164, 1044–1049. doi:10.1176/appi.ajp.164.7.1044.CrossRefGoogle ScholarPubMed
Givens, J. L. et al. (2006). Older patients’ aversion to antidepressants. A qualitative study. Journal of General Internal Medicine, 21, 146–151. doi:10.1111/j.1525-1497.2005.00296.x.Google ScholarPubMed
Hawton, K. and Van Heeringen, K. (2009). Suicide. Lancet, 373, 1372–1381. doi:10.1016/S0140-6736(09)60372-X.CrossRefGoogle ScholarPubMed
Hedenrud, T., Jonsson, P. and Linde, M. (2008). Beliefs about medicines and adherence among Swedish migraineurs. Annals of Pharmacotherapy, 42, 39–45. doi:10.1345/aph.1K354.CrossRefGoogle ScholarPubMed
Horne, R. and Weinman, J. (1999). Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. Journal of Psychosomatic Research, 47, 555–567.CrossRefGoogle ScholarPubMed
Hunot, V. M., Horne, R., Leese, M. N. and Churchill, R. C. (2007). A cohort study of adherence to antidepressants in primary care: the influence of antidepressant concerns and treatment preferences. Primary Care Companion to the Journal of Clinical Psychiatry, 9, 91–99.CrossRefGoogle ScholarPubMed
Lapierre, S. et al. (2011). A systematic review of elderly suicide prevention programs. Crisis, 32, 88–98. doi:10.1027/0227-5910/a000076.CrossRefGoogle ScholarPubMed
Lu, C. Y. and Roughead, E. (2012). New users of antidepressant medications: first episode duration and predictors of discontinuation. European Journal of Clinical Pharmacology, 68, 65–71. doi:10.1007/s00228-011-1087-3.CrossRefGoogle ScholarPubMed
Maidment, R., Livingston, G. and Katona, C. (2002). Just keep taking the tablets: adherence to antidepressant treatment in older people in primary care. International Journal of Geriatric Psychiatry, 17, 752–757. doi:10.1002/gps.688.CrossRefGoogle ScholarPubMed
Morin, J. et al. (2012). Alcohol use disorder in elderly suicide Attempters: a comparison study. American Journal of Geriatric Psychiatry, 21, 196–203. doi:10.1097/JGP.0b013e3182423b35.CrossRefGoogle Scholar
Osterberg, L. and Blaschke, T. (2005). Adherence to medication. New England Journal of Medicine, 353, 487–497. doi:10.1056/NEJMra050100.CrossRefGoogle ScholarPubMed
Paykel, E. S., Myers, J. K., Lindenthal, J. J. and Tanner, J. (1974). Suicidal feelings in the general population: a prevalence study. British Journal of Psychiatry, 124, 460–469.CrossRefGoogle ScholarPubMed
Pompili, M. et al. (2012). Temperaments mediate suicide risk and psychopathology among patients with bipolar disorders. Comprehensive Psychiatry, 53, 280–285. doi:10.1016/j.comppsych.2011.04.004.CrossRefGoogle ScholarPubMed
Pompili, M. et al. (2013). Mood disorders medications: predictors of nonadherence - review of the current literature. Expert Review of Neurotherapeutics, 13, 809–825. doi:10.1586/14737175.2013.811976.CrossRefGoogle ScholarPubMed
Rifai, A. H., George, C. J., Stack, J. A., Mann, J. J. and Reynolds, C. F. 3rd. (1994). Hopelessness in suicide attempters after acute treatment of major depression in late life. American Journal of Psychiatry, 151, 1687–1690.Google ScholarPubMed
Ruppar, T. M., Dobbels, F. and De Geest, S. (2012). Medication beliefs and antihypertensive adherence among older adults: a pilot study. Geriatric Nursing (New York, N.Y.), 33, 89–95. doi:10.1016/j.gerinurse.2012.01.006.CrossRefGoogle ScholarPubMed
Schuz, B. et al. (2011). Medication beliefs predict medication adherence in older adults with multiple illnesses. Journal of Psychosomatic Research, 70, 179–187. doi:10.1016/j.jpsychores.2010.07.014.CrossRefGoogle ScholarPubMed
Sherrill, J. T., Frank, E., Geary, M., Stack, J. A. and Reynolds, C. F. 3rd. (1997). Psychoeducational workshops for elderly patients with recurrent major depression and their families. Psychiatric Services, 48, 76–81.Google ScholarPubMed
Szanto, K., Mulsant, B. H., Houck, P., Dew, M. A. and Reynolds, C. F. 3rd. (2003). Occurrence and course of suicidality during short-term treatment of late-life depression. Archives of General Psychiatry, 60, 610–617. doi:10.1001/archpsyc.60.6.610.CrossRefGoogle ScholarPubMed
Szanto, K., Reynolds, C. F. 3rd, Conwell, Y., Begley, A. E. and Houck, P. (1998). High levels of hopelessness persist in geriatric patients with remitted depression and a history of attempted suicide. Journal of the American Geriatrics Society, 46, 1401–1406.CrossRefGoogle Scholar
Szanto, K. et al. (2001). Treatment outcome in suicidal vs. non-suicidal elderly patients. American Journal of Geriatric Psychiatry, 9, 261–268.CrossRefGoogle ScholarPubMed
Tyrer, P., Owen, R. T. and Cicchetti, D. V. (1984). The brief scale for anxiety: a subdivision of the comprehensive psychopathological rating scale. Journal of Neurology, Neurosurgery and Psychiatry, 47, 970–975.CrossRefGoogle ScholarPubMed
Van Der Laan, N. C., Schimmel, A. and Heeren, T. J. (2005). The applicability and the inter-rater reliability of the comprehensive psychopathological rating scale in an elderly clinical population. International Journal of Geriatric Psychiatry, 20, 35–40. doi:10.1002/gps.1244.CrossRefGoogle Scholar
Who Collaborating Centre for Drug Statistics Methodology (2012). Guidelines for ATC Classification and DDD Assignment 2013. Oslo.Google Scholar
Wiktorsson, S., Marlow, T., Runeson, B., Skoog, I. and Waern, M. (2011). Prospective cohort study of suicide attempters aged 70 and above: one-year outcomes. Journal of Affective Disorders, 134, 333–340. doi:10.1016/j.jad.2011.06.010.CrossRefGoogle ScholarPubMed
Wiktorsson, S., Runeson, B., Skoog, I., Ostling, S. and Waern, M. (2010). Attempted suicide in the elderly: characteristics of suicide attempters 70 years and older and a general population comparison group. American Journal of Geriatric Psychiatry, 18, 57–67. doi:10.1097/JGP.0b013e3181bd1c13.CrossRefGoogle Scholar
Yesavage, J. A. et al. (1982). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17, 37–49.CrossRefGoogle Scholar