In this study, since information regarding the patients’ annual f

In this study, since information regarding the patients’ annual family income was not available, accommodation in public housing estate was adopted as a proxy indicator reflecting

low socioeconomic status (Yu and Wong 2004). The finding of younger age and lower socioeconomic status as predictors for noncontinuous drug use echoed with a few previous studies (Hansen et al. 2004; Muzina et al. 2011; Sansone and Sansone 2012). Muzina et al. (2011) examined the adherence rates among antidepressant treated patients and found that a higher percentage of patients <65 years old were non-adherent. Similar results of poorer adherence Inhibitors,research,lifescience,medical in younger patients with bipolar disorders and schizophrenia had also been previously Inhibitors,research,lifescience,medical reported (Valenstein et al. 2006; Sajatovic et al. 2007). Higher level of overall perceived stigma at the start of treatment in younger depressive patient groups (Sirey et al. 2001a) and, as a result, refusal to accept physician's diagnosis of depression have all been postulated to be potential Inhibitors,research,lifescience,medical contributors to noncontinuous antidepressant use among younger patients (Van Voorhees et al. 2005). The problem was likely further complicated by the known Chinese culture in which misconceptions

about the indication and addiction potential of antidepressants was common (Yeung et al. 2004). The documentation of 16.1% of patients attempting Inhibitors,research,lifescience,medical to use antidepressants on an as-needed basis or at self-adjusted dosages was likely an underrepresentation of the actual scenario. Although not systematically assessed in this study, it is noteworthy that defaulting follow-ups (73.6% of noncontinuous users) and concerns of stigma over depression (n = 5, 5.7%) have been documented as the main reasons for noncontinuous use in our population. In fact, our findings concur with another study that suggested that Chinese Americans may feel uncomfortable taking the initiative to follow-up with Inhibitors,research,lifescience,medical their doctors even

if their symptoms fail to improve or they experience significant adverse effects (Yeung et al. 2004). Meanwhile, the Surgeon General’s report have identified that Asians and other minority groups tend to receive less mental health services than the Caucasians in the United States (Office of the Surgeon General (US) 2001). The two crotamiton modifiable risk factors to noncontinuous antidepressant use we identified were the number of follow-ups in clinic and side effects experienced by the patient. This finding was in line with a prospective randomized controlled trial conducted by Katon et al. (1995). Katon et al. (1995) reported that patients receiving increased intensity and frequency of visits over the first 4–6 weeks of treatment (visits 1 and 3 with a primary care physician, and visits 2 and 4 with a psychiatrist) had significantly greater drug adherence for 90 days or more (75.5% vs. 50.0%).

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