Research reportBelief in the harmfulness of antidepressants: Results from a national survey of the Australian public
Introduction
Surveys of the public in a number of developed countries have found that negative attitudes towards psychiatric medications are common (Angermeyer et al., 1993, Fischer et al., 1999, Goldney et al., 2001, Jorm et al., 1997a, Jorm et al., 1997b, Jorm et al., 1997c, Priest et al., 1996). These beliefs contrast sharply with the positive views of most health professionals (Caldwell and Jorm, 2000, Jorm et al., 1997b). Despite some recent professional debate about the balance of risks and benefits with antidepressants (Fergusson et al., 2005, Gunnell and Ashby, 2004), public attitudes have become more positive over time (Angermeyer and Matschinger, 2004, Jorm et al., in press, Paykel et al., 1998). Nevertheless, there is still a big gap between public and professional thinking. This gap presents a challenge to the implementation of evidence-based treatment for depression because it may affect willingness to seek help and adherence to prescribed treatments. Patient attitudes towards antidepressants have also been found to have a major effect on the cost-effectiveness of treatment, with negative attitudes associated with a lack of cost-effectiveness (Pyne et al., 2005).
The purpose of this paper is to present data from an Australian national survey on factors associated with the belief that antidepressants are harmful. Better understanding of the factors associated with this belief may help in the design and targeting of campaigns to improve depression literacy in the population. The factors examined in the study covered sociodemographic characteristics, exposure to depression, ability to recognize depression, beliefs about other depression interventions, beliefs about long-term outcomes with and without treatment, beliefs about causes, and stigmatizing attitudes.
Section snippets
Survey methodology
The survey methodology has been described previously (Jorm et al., 2005a, Jorm et al., 2005b). A household survey was carried out of Australian adults aged 18 or over by the company AC Nielsen. The achieved sample was 3998 persons and the response rate was 34%.
Survey interview
The interview was based on the one used in an earlier Australian survey (Jorm et al., 1997a, Jorm et al., 1997c), but with additional questions. The survey questions centered on a vignette of a person with a mental disorder. On a random
Prevalence of beliefs about antidepressants
For the depression vignette, 46.7% thought antidepressants would be helpful and 27.5% harmful. For the depression/suicidal vignette, the respective frequencies were 52.5% and 23.4%. Because the findings on factors associated with antidepressant beliefs were similar for the two vignettes, only the data on the depression/suicidal vignette are presented below. This vignette presents a more severely affected person who is clearly in need of intervention, so negative beliefs represent a more extreme
Discussion
We found that around a quarter of Australian adults believe that antidepressants would be harmful for a person who is depressed and suicidal. For a case of this severity, some action is clearly needed, so this belief is of particular concern.
Examination of factors associated with this belief gives some insight into its origin. To some extent it simply reflects lack of knowledge about depression, as shown by the association with less education, less exposure to depression, and poorer recognition
Conclusion
What are the implications of these findings for changing public beliefs? The findings suggest that belief in the harmfulness of antidepressants is associated with a general lack of exposure to depression, leading to an underestimation of its seriousness and of the necessity for intervention. Consequently, public campaigns may not need to focus specifically on antidepressants. A better approach might be to increase public awareness of depression and reduce stigma through media exposure to people
Acknowledgments
This study is part of the Australia–Japan Partnership, which is an agreement between the governments of the two countries for joint projects in areas of health. Funding for the survey was provided by the Australian Department of Health and Ageing, a National Health and Medical Research Council Program Grant, and “beyondblue: the national depression initiative”. We thank Kelly Blewitt for her assistance with the survey.
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2012, Journal of Affective DisordersCitation Excerpt :Similar associations between exposure to treatment and more positive beliefs have been seen in other surveys (Aikens et al., 2008; Dahlberg et al., 2008) Notably, in the 2011 survey, unlike the 2003/2004 survey (Jorm et al., 2005a); level of education was not associated with belief in harmfulness. Examination of changes over time showed that this lack of difference in 2011 was due to a greater fall in belief in harmfulness in those with a lower level of education than in those with a higher level of education.