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10 - Cultural factors and the use of psychotropic medications

Published online by Cambridge University Press:  22 August 2009

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
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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