Patterns, predictors, and patient-reported reasons for antidepressant discontinuation in the WHO World Mental Health Surveys

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• dc.contributor.author Kazdin, Alan E.
• dc.contributor.author Alonso Caballero, Jordi
• dc.contributor.author WHO World Mental Health Survey Collaborators
• dc.date.accessioned 2024-06-04T14:02:48Z
• dc.date.available 2024-06-04T14:02:48Z
• dc.date.issued 2024
• dc.description.abstract Background: Despite their documented efficacy, substantial proportions of patients discontinue antidepressant medication (ADM) without a doctor's recommendation. The current report integrates data on patient-reported reasons into an investigation of patterns and predictors of ADM discontinuation. Methods: Face-to-face interviews with community samples from 13 countries (n = 30 697) in the World Mental Health (WMH) Surveys included n = 1890 respondents who used ADMs within the past 12 months. Results: 10.9% of 12-month ADM users reported discontinuation-based on recommendation of the prescriber while 15.7% discontinued in the absence of prescriber recommendation. The main patient-reported reason for discontinuation was feeling better (46.6%), which was reported by a higher proportion of patients who discontinued within the first 2 weeks of treatment than later. Perceived ineffectiveness (18.5%), predisposing factors (e.g. fear of dependence) (20.0%), and enabling factors (e.g. inability to afford treatment cost) (5.0%) were much less commonly reported reasons. Discontinuation in the absence of prescriber recommendation was associated with low country income level, being employed, and having above average personal income. Age, prior history of psychotropic medication use, and being prescribed treatment from a psychiatrist rather than from a general medical practitioner, in comparison, were associated with a lower probability of this type of discontinuation. However, these predictors varied substantially depending on patient-reported reasons for discontinuation. Conclusion: Dropping out early is not necessarily negative with almost half of individuals noting they felt better. The study underscores the diverse reasons given for dropping out and the need to evaluate how and whether dropping out influences short- or long-term functioning.
• dc.format.mimetype application/pdf
• dc.identifier.citation Kazdin AE, Harris MG, Hwang I, Sampson NA, Stein DJ, Viana MC, et al. Patterns, predictors, and patient-reported reasons for antidepressant discontinuation in the WHO World Mental Health Surveys. Psychol Med. 2024 Jan;54(1):67-78. DOI: 10.1017/S0033291723002507
• dc.identifier.doi http://dx.doi.org/10.1017/S0033291723002507
• dc.identifier.issn 0033-2917
• dc.identifier.uri http://hdl.handle.net/10230/60348
• dc.language.iso eng
• dc.publisher Cambridge University Press
• dc.relation.ispartof Psychol Med. 2024 Jan;54(1):67-78
• dc.rights This article has been published in a revised form in Psychological medicine [http://doi.org/10.1017/S0033291723002507]. This version is published under a Creative Commons CC-BY-NC-ND licence. No commercial re-distribution or re-use allowed. Derivative works cannot be distributed. © [Copyright © 2023, Cambridge University Press].
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword Antidepressants
• dc.subject.keyword Major depressive disorder
• dc.subject.keyword Medication discontinuation
• dc.title Patterns, predictors, and patient-reported reasons for antidepressant discontinuation in the WHO World Mental Health Surveys
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion