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17 - Depression and adherence to medical advice

from Part 3 - Biological and behavioural processes

Published online by Cambridge University Press:  17 September 2009

By
Douglas A. Raynor ,
Rena R. Wing  and
Suzanne Phelan
Edited by
Andrew Steptoe
Douglas A. Raynor
Affiliation:
Department of Psychology, State University of New York, Geneseo, NY, USA
Rena R. Wing
Affiliation:
Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA
Suzanne Phelan
Affiliation:
Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA
Andrew Steptoe
Affiliation:
University College London
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Summary

The coexistence of depression and medical illness has been the focus of a great deal of attention in the past several years. Depression appears to occur in at least 25% of medical patients, although estimates vary based on measurement criteria, type and stage of medical disease, and level of depressive severity [1, 2]. Depression has also been associated with poorer health outcomes in these diseases. Depression may influence the development and progression of diseases directly via physiological pathways or indirectly via behavioural pathways [3].

Adherence to treatment regimens is one possible behavioural pathway by which depression affects physical health. Adherence is the degree to which a person's behaviour (e.g. taking medications, attending treatment sessions, executing lifestyle changes) coincides with medical or health advice [4]. Adherence is critical for the prevention and treatment of medical diseases. Unfortunately, adherence is less than optimal across a wide range of medical regimens [5]. Individuals who are depressed may be less likely to adhere to various aspects of their treatment regimens, and this lack of adherence may produce poorer health outcomes.

There is a large literature on predictors of adherence. A substantial number of variables have been associated with adherence, but findings across studies have been inconsistent [6]. Depression has emerged as one of the few promising predictors of treatment adherence among medical patients [7]. There are many reasons to hypothesise that depression may negatively influence an individual's willingness and capacity to adhere to a treatment regimen.

Keywords

adherence to medical regimensdepressionempirical studieshuman immunodeficiencyvirusmedical patients
Type
Chapter
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Depression and Physical Illness , pp. 369 - 394
Publisher: Cambridge University Press
Print publication year: 2006

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  • Depression and adherence to medical advice
    • By Douglas A. Raynor, Department of Psychology, State University of New York, Geneseo, NY, USA, Rena R. Wing, Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA, Suzanne Phelan, Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA
  • Edited by Andrew Steptoe, University College London
  • Book: Depression and Physical Illness
  • Online publication: 17 September 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544293.018
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  • Depression and adherence to medical advice
    • By Douglas A. Raynor, Department of Psychology, State University of New York, Geneseo, NY, USA, Rena R. Wing, Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA, Suzanne Phelan, Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA
  • Edited by Andrew Steptoe, University College London
  • Book: Depression and Physical Illness
  • Online publication: 17 September 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544293.018
Available formats
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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Depression and adherence to medical advice
    • By Douglas A. Raynor, Department of Psychology, State University of New York, Geneseo, NY, USA, Rena R. Wing, Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA, Suzanne Phelan, Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA
  • Edited by Andrew Steptoe, University College London
  • Book: Depression and Physical Illness
  • Online publication: 17 September 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544293.018
Available formats
×