Study On Drug Compliance And Its Influencing Factors In Patients With Unipolar And Bipolar Depression

Objective: This paper has explored the similarities and differences of medication compliance between unipolar and bipolar depression,and discussed the possible mechanisms of psychology and cognition,which provide theoretical basis for medical staff to take targeted interventions to improve patients' medication compliance.Methods: A total of 182 depression patients in episodes were collected from Jining Psychiatric Hospital from February 1,2019 to December 31,2019,which includes 132 unipolar depression patients and 47 bipolar depression patients.Self-made general situation questionnaire,alexithymia scale(TAS-26),Baker depression self-assessment scale(BDI-21),cognitive coping strategy questionnaire(CERQ-C),trait anxiety questionnaire(T-AI),perceived social support scale(PSSS)and the Chinese version of the antidepressant medication compliance questionnaire(ADCQ-C)were used to evaluate the two groups of patients.All data were analyzed by SPSS20.0 software.T-test,chi-square test,correlation analysis and multiple stepwise regression model were used to compare and analyze the compliance and influencing factors.Results:1.Unipolar depression had a higher female / male ratio and age of onset than bipolar depression.The course of bipolar depression,disease duration,positive family history,and previous hospitalizations were higher than those ofunipolar depression(P?0.05).2.The scores of compliance index and cognition of doctor-patient relationship were higher in bipolar depression patients than in unipolar depression(P < 0.05).There were significant differences in ADCQ-C's factors among unipolar depression patients with different education background,marital status and family structure.There were significant differences in some factors of ADCQ-C among bipolar depression patients with different marital status,family structure and economic status(P < 0.05).3.There were significant correlations between ADCQ-C's partial factors of unipolar and bipolar depression and BDI total score,partial factors of TAS-26,partial factors of CERQ-C,T-AI,and partial factors of PSSS(P <0.01 or P<0.05).4.In unipolar depression,PSSS's understanding family support,taking antipsychotics or not,and CERQ-C's refocusing plan entered the regression equation of ADCQ-C's overall compliance.Age,the ability of TAS-26 to recognize and distinguish emotions and somatosensory feelings,the ability to comprehend family support,and CERQ-C's acceptance factor entered the regression equation of understanding doctor-patient relationship.The catastrophic factors of CERQ-C,the ability of TAS-26 to describe emotions,and the family structure entered the regression equation of ADCQ-C's autonomy maintenance,where the ability of TAS-26 to describe emotions played an intermediary role between family structure and autonomymaintenance,and the mediation effect accounted for 31.35%.TAS-26's fantasy,trait anxiety score and marital status entered the regression equation of ADCQ-C's attitude and belief in antidepressant drug treatment.5.In bipolar depression,PSSS's out of family support factor and depression entered into the regression equation of ADCQ-C's overall compliance.PSSS's other support factor,course of disease and family structure entered into the regression equation of understanding the doctor-patient relationship.CERQ-C's blaming others,CERQ-C's paying attention to the plan again,TAS-26's ability to describe emotions,the number of drugs taken,and economic status entered into the regression equation of autonomous maintenance.The level of depression and the number of previous hospitalizations entered the regression equation of ADCQ-C's attitude and belief in antidepressant drug treatment.Conclusion:1.In terms of overall medication compliance and cognition of doctor-patient relationship,bipolar depression performed better than unipolar depression.2.For patients with unipolar depression,PSSS's family support factor,whether to take antipsychotic drugs,and the CERQ-C refocusing plan were the influencing factors of their overall compliance,and taking antipsychotic drugs was a risk factor.Age,the ability of TAS-26 to recognize and distinguish emotions and somatosensory feelings,PSSS'sfamily support factor,and CERQ-C acceptance strategies were protective factors for patients to understand the relationship between doctors and patients.The catastrophic of CERQ-C,the ability of TAS-26 to describe emotions,and the family structure were risk factors for patients to maintain their autonomy,in which the family structure had an indirect effect on the maintenance of autonomy,partly through the ability of TAS-26 to describe emotions.TAS-26's fantasy,trait anxiety,and marital status were factors that influence patients' attitude and beliefs about antidepressant drug therapy,in which TAS-26's fantasy factor was a protective factor.3.For patients with bipolar depression,PSSS's out of family support factor and depression level had an impact on their overall compliance,with depression level being a risk factor.PSSS's other support factor,course of illness,and family structure were the influencing factors of patients' understanding of the relationship between doctors and patients,and the non-core family structure type was a risk factor.CERQ-C's blaming others,CERQ-C's refocusing on the plan,the ability of TAS-26 to describe emotions,the number of medications,and economic status had an impact on the patient's autonomy,among which the ability of TAS-26 to describe emotions,the economic condition and the CERQ-C's refocusing on the plan were protective factors.The level of depression and the number of previous hospitalizations had an impact on patients' attitudes and beliefs about antidepressant drug treatment,in which the level of depression was a risk factor.