Social Psychiatry and Psychiatric Epidemiology

, Volume 47, Issue 12, pp 1985–1998

Economic factors in of patients’ nonadherence to antidepressant treatment

Original Paper



Patients’ nonadherence to antidepressant treatment hampers cost and efficacy of depression-specific treatment. However, previous studies have failed to find consistent findings in economic effect on nonadherence and also failed to reach consensus in how to measure nonadherence to treatment. The study attempts to investigate income effect on nonadherence to selective serotonin reuptake inhibitors (SSRIs) treatment with clear definitions of nonadherence: self discontinuation of SSRIs (nonpersistence) and under-dose of SSRIs (noncompliance).


The study extracted data from the National Comorbidity Survey-Replication (NCS-R). The study sample (n = 280) includes adults between the ages of 18 and 64 who were diagnosed with Diagnostic Statistics Manual IV Major Depressive Episode (MDE) at some point during their lifetime and medicated with SSRIs in the past 12 months.


Just above poverty level of family income and no health insurance increased the risk of medication nonpersistence in SSRIs treatment. The study findings confirmed that African Americans were at higher risk of medication noncompliance than Whites (odds ratio, 4.53) and MDE comorbidity was positively associated with medication noncompliance (odds ratio, 4.25).


Low income level, combined with health insurance status, and race/ethnicity, predict nonadherence to antidepressant treatment. The study findings would help physicians and hospitals developing interventional strategies and programs to increase patients’ adherence rates in antidepressant treatment.


Medication nonadherence Antidepressants Income Health insurance 


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© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Department of Psychiatry and Behavioral SciencesCollege of Medicine, The University of Oklahoma Health Sciences CenterOklahoma CityUSA

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