Cultural factors and the use of psychotropic medications

doi:10.1017/CBO9780511544149.011

10 - Cultural factors and the use of psychotropic medications

Published online by Cambridge University Press: 22 August 2009

Chee H. Ng and

Steven Klimidis

Edited by

Chee H. Ng ,

Keh-Ming Lin ,

Bruce S. Singh and

Edmond Y. K. Chiu

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Chee H. Ng: Affiliation:
Department of Psychiatry, The University of Melbourne, St Vincent Hospital & The Melbourne Clinic, Victoria, Australia
Steven Klimidis: Affiliation:
Centre for International Mental Health, School of Population Health, The University of Melbourne, Victoria, Australia
Chee H. Ng: Affiliation:
University of Melbourne
Keh-Ming Lin: Affiliation:
National Health Research Institutes, Taiwan
Bruce S. Singh: Affiliation:
University of Melbourne
Edmond Y. K. Chiu: Affiliation:
University of Melbourne

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Summary

Culture and attitudes towards medications

The prescription and use of medications fundamentally involves a social transaction that carries both symbolic and social meanings based on the interactions between the patient, doctor, and their social environment (Moerman, 1979). Consequently medication uptake and use is considerably influenced by sociocultural factors, ultimately influencing therapeutic benefit, as first surmised by Murphy (1969). Cross-cultural and cross-ethnic differences in drug response are considerable, and beyond explanations based simply on the biological effects of the medication. Sociocultural factors include beliefs and expectations concerning the illness, the treatment and its mechanisms of action, compliance behavior, the role of the social network in using medicines, propensity to placebo effects, and use of alternative or concurrent herbal and other strategies from traditional medicines. The patient's willingness to accept medication is related to cross-cultural variability in drug tolerance and metabolism, as well as past experiences and current beliefs and perceptions held about psychiatric drugs.

Sociocultural, illness, and biological factors affect individual attitudes towards psychotropic medications. Health beliefs or explanatory models, particularly causal attributions regarding the illness and the treatment options afforded within such models, exert a profound influence on patients' attitudes and behavior regarding medications (Smith, Lin & Mendoza, 1993). Such effects can be subtle and can occur during the course of treatment even if there has been initial successful negotiation about the nature of the illness and treatment.

Type: Chapter
Information: Ethno-psychopharmacology
Advances in Current Practice
, pp. 123 - 134

DOI: https://doi.org/10.1017/CBO9780511544149.011 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2008

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References

Ajzen, I. (2001). Nature and operation of attitudes. Annu. Rev. Psychol., 52, 27–58.Google Scholar

Angel, R. & Thoits, P. (1987). The impact of culture on the cognitive structure of illness. Cult. Med. Psychiatry, 11, 465–94.Google Scholar

Awad, A. G. (1993). Subjective response to neuroleptics in schizophrenia. Schizophr. Bull., 19, 609–18.Google Scholar

Awad, A. G., Hogan, T. P., Voruganti, L. N. & Heslegrave, R. J. (1995). Patient's subjective experiences on antipsychotic medications: implications for outcome and quality of life. Int. Clin. Psychopharmacol., 10, 123–32.Google Scholar

Bourgeois, J. A. (2005). Compliance with psychiatric treatment in primary care: review and strategies. Prim. Psychiatry, 12, 40–7.Google Scholar

Buckalew, L. W. & Coffield, K.. (1982). Drug expectations associated with perceptual characteristics. Percept. Mot. Skills, 55, 915–18.Google Scholar

Carder, P. C., Vuckovic, N. & Green, C. A. (2003). Negotiating medications: patient perceptions of long-term medication use. J. Clin. Pharm. Ther., 28, 409–17.Google Scholar

David, A. S. (1990). Insight and psychosis. Br. J. Psychiatry, 156, 798–808.Google Scholar

Day, J. C., Bentall, R. P., Roberts, C.et al. (2005). Attitudes toward antipsychotic medication. Arch. Gen. Psychiatry, 62, 717–24.Google Scholar

Escobar, J. I. & Tuason, V. B. (1980). Antidepressant agents: a cross-cultural study. Psychopharmacol. Bull., 16, 49–52.Google Scholar

Fenton, W. S., Blyler, C. R. & Heinssen, R. K. (1997). Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophr. Bull., 23, 637–51.Google Scholar

Gillis, L. S., Trollip, D., Jakoet, A. & Holden, T. (1987). Non-compliance with psychotropic medi- cation. S. Afr. Med. J., 72(9), 602–6.Google Scholar

Hogan, T. P., Awad, A. G. & Eastwood, R. (1983). A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity. Psychol. Med., 13, 177–83.Google Scholar

Horne, R. & Weinman, J. (1999). Patients' beliefs about prescribed medicines and their role in adherence to treatment in chronic physical disease. J. Psychosom. Res., 47(6), 555–67.Google Scholar

Horne, R., Graupner, L., Frost, S.et al. (2004). Medicine in a multi-cultural society: the effect of cultural background on beliefs about medications. Soc. Sci. Med., 59, 1307–13.Google Scholar

Kampman, O., Lehtinen, K., Lassila, V.et al. (2000). Attitudes towards neuroleptic treatment: reliability and validity of the Attitudes towards Neuroleptic Treatment (ANT) questionnaire. Schizophr. Res., 45, 223–34.Google Scholar

Kinzie, J. D., Leung, P., Boehnlein, J. K. & Fleck, J. (1987). Antidepressant blood levels in Southeast Asians. Clinical and cultural implications. J. Nerv. Ment. Dis., 175(8), 480–5.Google Scholar

Kleinman, A. (1988). Rethinking Psychiatry. New York: Free Press.

Lee, R. P. L. (1980). Perceptions and uses of Chinese medicine among the Chinese in Hong Kong. Cult. Med. Psychiatry, 4, 345–75.Google Scholar

Lee, S. (1993). Side effect of chronic lithium therapy in Hong Kong Chinese: an ethnopsychiatric perspective. Cult. Med. Psychiatry, 17, 301–20.Google Scholar

Leventhal, H., Diefenbach, M. & Leventhal, E. A. (1992). Illness cognition: using common sense to understand treatment adherence and affect cognition interactions. Cogn. Ther. Res., 16, 143–63.Google Scholar

Lin, K.-M. & Shen, W. W. (1991). Pharmacotherapy for Southeast Asian psychiatric patients. J. Nerv. Ment. Dis., 179, 346–50.Google Scholar

Lin, K.-M., Miller, M. H., Poland, R. E., Nuccio, I. & Yamaguchi, M. (1991). Ethnicity and family involvement in the treatment of schizophrenic patients. J. Nerv. Ment. Dis., 179, 631–3.Google Scholar

Lin, K.-M., Poland, R. E. & Silver, B. (1993). Overview: the interface between psychobiology and ethnicity. In Lin, K. M., Poland, R. E. and Nakasaki, G., eds., Psychopharmacology and Psychobiology of Ethnicity.Washington, DC: American Psychiatric Press, pp. 11–35.

Mantonakis, J., Markidis, M., Kontaxakis, V. & Liakos, A. (1985). A scale for detection of negative attitudes towards medication among relatives of schizophrenic patients. Acta Psychiatr. Scand., 71, 186–9.Google Scholar

Moerman, D. E. (1979). Anthropology of symbolic healing. Curr. Anthropology, 20, 59–80.Google Scholar

Morisky, D. E., Green, L. W. & Levine, D. M. (1986). Concurrent and predictive validity of a self-reported measure of medication adherence. Med. Care, 24, 67–74.Google Scholar

Murphy, H. B. M. (1969). Ethnic variations in drug response. Transcultural Psychiatric Research Review, 6, 6–23.Google Scholar

Ng, C. (1997). The stigma of mental illness in Asian cultures. Aust. N. Z. J. Psychiatry, 31, 382–90.Google Scholar

Ng, C., Chong, S. A., Lambert, T.et al. (2005). An interethnic comparison study of clozapine dosage, clinical response and plasma levels. Int. Clin. Psychopharmacol., 20, 163–8.Google Scholar

Ng, C., Norman, T., Naing, K. O.et al. (2006). A comparison study of sertraline dosages and response in Chinese versus Caucasian patients. J. Int. Clin. Psychopharmacol., 21, 87–92.Google Scholar

Nutting, P. A., Post, K., Smith, J., Werner, J. J. & Elliot, C. (2000). Competing demands from physical problems: effect on initiating and completing depression care over 6 months. Arch. Fam. Med., 9, 1959–64.Google Scholar

Parker, G., Gladstone, G. & Chee, K.-T. (2001). Depression in the planet's largest ethnic group: the Chinese. Am. J. Psychiatry, 158, 857–64.Google Scholar

Priebe, S. (1987). Early subjective reactions predicting outcome of hospital treatment in depressive patients. Acta Psychiatr. Scand., 76, 134–8.Google Scholar

Seale, C., Chaplin, R., Lelliott, P. & Quirk, A. (2006). Sharing decisions in consultations involving anti-psychotic medication: a qualitative study of psychiatrists' experiences. Soc. Sci. Med., 62, 2861–73.Google Scholar

Smith, M., Lin, K. M. & Mendoza, R. (1993). Non-biological issues affecting psychopharmacotherapy: cultural considerations. In Lin, K. M., Poland, R. E. and Nakasaki, G., eds., Psychopharmacology and Psychobiology of Ethnicity. Washington DC: American Psychiatric Press, pp. 37–58.

Swartzman, L. C. & Burkell, J. (1998). Expectations and the placebo effect in clinical drug trials: why we should not turn a blind eye to unblinding, and other cautionary notes. Clin. Pharmacol. Ther., 64, 1–7.Google Scholar

Thompson, K., Kulkarni, J. & Sergejew, A. (2000). Reliability and validity of a new Medication Adherence Rating Scale (MARS) for the psychoses. Schizophr. Res., 42, 241–7.Google Scholar

Tung, T. M. (1985). Psychiatric care for Southeast Asian patients: how different is different? In Owan, T., Bliatout, B., Lin, K. M.et al., eds., Southeast Asian Mental Health: Treatment, Prevention, Services and Research. Rockville, MD: National Institute of Mental Health.

Putten, T. & May, P. R. A. (1978). Subjective response as a predictor of outcome in pharmacotherapy. Arch. Gen. Psychiatry, 35, 477–80.Google Scholar

Voruganti, L. N. P. & Awad, A. G. (2002). Personal evaluation of transitions in treatment (PETiT): a scale to measure subjective aspects of antipsychotic drug therapy in schizophrenia. Schizophr. Res., 56, 37–46.Google Scholar

Wertheimer, A. I. & Santella, T. M. (2003). Medication compliance research: still far to go. J. of Applied Res. in Clin. and Exp. Therapeutics, 3(3), (http://jrnlappliedresearch.com/articles/Vol3Iss3/Wertheimer.htm).Google Scholar

Westermeyer, J. (1989). Somatotherapies. In Gold, J. H., ed., Psychiatric Care of Migrants: A Clinical Guide. Washington: American Psychiatric Press, pp. 139–68.

Ziguras, S. J., Klimidis, S., Lambert, T. J. R. & Jackson, A. C. (2001). Determinants of anti-psychotic medication compliance in a multicultural population. Community Ment. Health J., 37(3), 273–83.

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