The low level of understanding of depression among patients treated with antidepressants: a survey of 424 outpatients in Japan

Abstract

Shuhei Kudo,1 Tetsu Tomita,1 Norio Sugawara,1,2 Yasushi Sato,1 Masamichi Ishioka,3 Koji Tsuruga,4 Taku Nakagami,5 Kazuhiko Nakamura,1 Norio Yasui-Furukori1 1Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, 2Aomori Prefectural Center for Mental Health and Welfare, Aomori, 3Department of Psychiatry, Hirosaki Aiseikai Hospital, Hirosaki, 4Department of Psychiatry, Aomori Prefectural Tsukushigaoka Hospital, Aomori, 5Department of Neuropsychiatry, Odate City General Hospital, Odate, Japan Background: We used self-administered questionnaires to investigate the level of understanding of depression among outpatients who were administered antidepressants. Methods: A total of 424 outpatients were enrolled in this study. We used an original self-administered questionnaire that consisted of eight categories: (A) depressive symptoms, (B) the course of depression, (C) the cause of depression, (D) the treatment plan, (E) the duration of taking antidepressants, (F) how to discontinue antidepressants, (G) the side effects of the antidepressants, and (H) psychotherapy. Each category consisted of the following two questions: “Have you received an explanation from the doctor in charge?” and “How much do you understand about it?” The level of understanding was rated on a scale of 0–10 (11 anchor points). The Quick Inventory of Depressive Symptomatology Japanese version, Global Assessment of Functioning, and Clinical Global Impression – Severity scale were administered, and clinical characteristics were investigated. Results: The percentages of participants who received explanations were as follows: 61.8% for (A), 49.2% for (B), 50.8% for (C), 57.2% for (D), 46.3% for (E), 28.5% for (F), 50.6% for (G), and 36.1% for (H). The level of understanding in participants who received explanations from their physicians was significantly higher compared with patients who did not receive explanations for all evaluated categories. Patient age, age at disease onset, and Global Assessment of Functioning scores were significantly associated with more items compared with the other variables. Conclusion: Psychoeducation is not sufficiently performed. According to the study results, it is possible for patients to receive better psychoeducation and improve their clinical outcomes. Keywords: depression, psychoeducation, antidepressant, questionnaire