Halim, Rahilah and Kaur, Manveen and Mokhtar, Sharifah Suziah Syed and Chemi, Norliza and Sajatovic, Martha and Tan, Yee Kee and Siau, Ching Sin and Ng, Chong Guan (2025) The Association Between Medication Adherence Internalized Stigma and Social Support Among Outpatients with Major Depressive Disorder in a Malaysian Hospital: A Cross-Sectional Study. Psychology Research and Behavior Management, 18. pp. 209-223. ISSN 1179-1578, DOI https://doi.org/10.2147/PRBM.S485333.
Full text not available from this repository.Abstract
Background: Internalized stigma and medication non-adherence pose significant challenges for treating major depressive disorder (MDD), leading to disability, increased suicide risk, and morbidity. Limited data exists on modifiable factors associated with adherence in lower-resourced settings like Malaysia. This study aimed to investigate poor adherence prevalence and the demographic and clinical factors associated with poor medication adherence among patients with MDD. Methods: This cross-sectional survey recruited participants using universal sampling from a major hospital in Selangor, Malaysia. Participants answered questionnaires consisting of demographic and clinical information (medical history, duration of anti-depressant treatment for MDD, psychiatric ward admission history, and any medication side effects experienced), the Internalized Stigma of Mental Illness Scale (comprising alienation, stereotype, perceived discrimination, and social withdrawal), the Multidimensional Scale of Perceived Social Support (comprising family, friend, and significant other support), and the Malaysia Medication Adherence Assessment Tool. Simple and multiple logistic regression and mediation analyses were conducted. Results: Of the 268 participants (69% female), 57.1% were suboptimally or moderately adherent to their medication. Buddhists (adjusted odds ratio aOR] = 0.280, 95% CI 0.115, 0.679], p = 0.005), higher family support (aOR = 0.753, 95% CI 0.591, 0.960], p = 0.022), a history of ward admissions (aOR = 3.523, 95% CI 1.537, 8.072], p = 0.003), and higher internalized stigma (aOR = 2.828, 95% CI 1.497, 5.344], p = 0.001) were significantly associated with low/moderate medication adherence. The effect of internalized stigma subdomains (alienation, perceived discrimination, and social withdrawal) on medication adherence were partially mediated by family support. Conclusion: More than half of the participants demonstrated low to moderate medication adherence. Those with higher internalized stigma demonstrated higher odds of low/moderate medication adherence, but this effect was attenuated by family support. Therefore, internalized stigma and family support are important points of consideration when assessing patients with MDD in Malaysia.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | medication adherence; MDD; internalized stigma; social support; Malaysia |
| Subjects: | B Philosophy. Psychology. Religion > BF Psychology R Medicine > RZ Other systems of medicine |
| Divisions: | Faculty of Medicine > Psychological Medicine Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 23 Apr 2025 01:48 |
| Last Modified: | 23 Apr 2025 01:48 |
| URI: | http://eprints.um.edu.my/id/eprint/48031 |
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