Early self-reported medication non-adherence in depression: A hospital-based prospective study from Northeast India
Year: 2026
Type: article
Study design: Observational Study
Abstract: ABSTRACT Background: Early medication nonadherence represents a critical barrier to achieving optimal outcomes in major depressive disorder (MDD). Despite India’s high depression burden, only a few studies have examined psychosocial factors associated with early nonadherence in routine clinical settings. Aim: To evaluate the prevalence and psychosocial factors associated with early self-reported medication nonadherence in depression within 1 month of treatment in a psychiatric outpatient department. Methods: A prospective cohort study included 101 adults diagnosed with MDD at a tertiary hospital in Northeast India who were antidepressant-naïve for the current episode and attended their first follow-up within a month. Sociodemographic and clinical factors, depression severity, and stigma were assessed at baseline. Medication adherence and medication attitudes were assessed at follow-up. Results: Early self-reported medication nonadherence occurred in 27.7% of patients. In bivariate analysis, nonadherence was associated with longer episode duration, treatment-emergent side effects, higher personal and perceived stigma, and poorer medication attitudes. In logistic regression, higher perceived stigma was associated with increased odds of early medication nonadherence (OR = 1.31, 95% CI: 1.04 to 1.67, P = .015) and higher drug attitude scores were associated with lower odds (OR = 0.76, 95% CI: 0.64 to 0.90, P < .001), whereas sociodemographic variables did not show a significant association. Conclusion: Nearly one-third of MDD patients self-reported early medication nonadherence. Psychosocial determinants, particularly stigma and negative medication attitudes, played a greater role than demographic or clinical factors. Early psychoeducation and stigma-reduction strategies could be crucial for enhancing medication adherence and improving treatment outcomes in depression.
Source: Indian Journal of Psychiatry
Institution: Sikkim Manipal University
Language: English
Subfield: Family Practice
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223120577