What Do Patients Want in the Treatment of Major Depressive Disorder? Taiwan’s TAILOR Survey

Abstract In Taiwan, the number of patients being treated for depression has been increasing over recent decades, but there remain some key unmet needs for these patients. One issue is the low rate of help-seeking, which may be at least partially attributable to the stigma of depression in Asian soci...

Full description

Bibliographic Details
Main Author: Chia-Ming Chang
Format: Article
Language:English
Published: Adis, Springer Healthcare 2023-04-01
Series:Neurology and Therapy
Subjects:
Online Access:https://doi.org/10.1007/s40120-023-00471-y
_version_ 1797836149234860032
author Chia-Ming Chang
author_facet Chia-Ming Chang
author_sort Chia-Ming Chang
collection DOAJ
description Abstract In Taiwan, the number of patients being treated for depression has been increasing over recent decades, but there remain some key unmet needs for these patients. One issue is the low rate of help-seeking, which may be at least partially attributable to the stigma of depression in Asian societies. Stigma also contributes to underdiagnosis, because stigmatised patients may emphasise somatic symptoms (e.g. lethargy/fatigue, sleep disorders or changes in appetite), fearing how they will be perceived if they discuss psychological symptoms with their physician. Underdiagnosis may also result from cross-cultural differences, because assessment scales and screening tools are usually developed in Western populations and may not have the same validity in Asian patients. Depression in Taiwan appears to be undertreated, with a high rate of suboptimal antidepressant dosages and inadequate duration of therapy. Patients may discontinue treatment earlier than recommended for a number of reasons related to their own beliefs about treatment, their relationship with their physicians, or the effects of the medication (adverse effects, slow onset of effect, or lack of effect on comorbid symptoms). Moreover, frequently there is discordance between how patients and physicians define treatment success in depression. Patients are more likely to achieve a benefit from treatment which remains persistent when physicians and patients are closely aligned on treatment goals. To better understand the experiences, preferences and attitudes of patients with depression in Taiwan, the Target Antidepressant Initiation choice to unLock positive patient Outcomes and Response (TAILOR) survey was conducted in 340 adult outpatients receiving treatment for major depressive disorder (MDD). The results of the TAILOR survey highlight the personal and perceived stigma of depression, current barriers to seeking help and maintaining treatment, and opportunities to improve shared decision-making, medication adherence and clinical outcomes for Taiwanese patients with MDD.
first_indexed 2024-04-09T15:05:07Z
format Article
id doaj.art-607b6419158a44f29577626d46f3250b
institution Directory Open Access Journal
issn 2193-8253
2193-6536
language English
last_indexed 2024-04-09T15:05:07Z
publishDate 2023-04-01
publisher Adis, Springer Healthcare
record_format Article
series Neurology and Therapy
spelling doaj.art-607b6419158a44f29577626d46f3250b2023-04-30T11:32:11ZengAdis, Springer HealthcareNeurology and Therapy2193-82532193-65362023-04-0112S1212910.1007/s40120-023-00471-yWhat Do Patients Want in the Treatment of Major Depressive Disorder? Taiwan’s TAILOR SurveyChia-Ming Chang0Department of Psychiatry, Chang Gung Memorial Hospital at LinkoAbstract In Taiwan, the number of patients being treated for depression has been increasing over recent decades, but there remain some key unmet needs for these patients. One issue is the low rate of help-seeking, which may be at least partially attributable to the stigma of depression in Asian societies. Stigma also contributes to underdiagnosis, because stigmatised patients may emphasise somatic symptoms (e.g. lethargy/fatigue, sleep disorders or changes in appetite), fearing how they will be perceived if they discuss psychological symptoms with their physician. Underdiagnosis may also result from cross-cultural differences, because assessment scales and screening tools are usually developed in Western populations and may not have the same validity in Asian patients. Depression in Taiwan appears to be undertreated, with a high rate of suboptimal antidepressant dosages and inadequate duration of therapy. Patients may discontinue treatment earlier than recommended for a number of reasons related to their own beliefs about treatment, their relationship with their physicians, or the effects of the medication (adverse effects, slow onset of effect, or lack of effect on comorbid symptoms). Moreover, frequently there is discordance between how patients and physicians define treatment success in depression. Patients are more likely to achieve a benefit from treatment which remains persistent when physicians and patients are closely aligned on treatment goals. To better understand the experiences, preferences and attitudes of patients with depression in Taiwan, the Target Antidepressant Initiation choice to unLock positive patient Outcomes and Response (TAILOR) survey was conducted in 340 adult outpatients receiving treatment for major depressive disorder (MDD). The results of the TAILOR survey highlight the personal and perceived stigma of depression, current barriers to seeking help and maintaining treatment, and opportunities to improve shared decision-making, medication adherence and clinical outcomes for Taiwanese patients with MDD.https://doi.org/10.1007/s40120-023-00471-yAntidepressantsDepressionPersistenceStigmaUnmet needs
spellingShingle Chia-Ming Chang
What Do Patients Want in the Treatment of Major Depressive Disorder? Taiwan’s TAILOR Survey
Neurology and Therapy
Antidepressants
Depression
Persistence
Stigma
Unmet needs
title What Do Patients Want in the Treatment of Major Depressive Disorder? Taiwan’s TAILOR Survey
title_full What Do Patients Want in the Treatment of Major Depressive Disorder? Taiwan’s TAILOR Survey
title_fullStr What Do Patients Want in the Treatment of Major Depressive Disorder? Taiwan’s TAILOR Survey
title_full_unstemmed What Do Patients Want in the Treatment of Major Depressive Disorder? Taiwan’s TAILOR Survey
title_short What Do Patients Want in the Treatment of Major Depressive Disorder? Taiwan’s TAILOR Survey
title_sort what do patients want in the treatment of major depressive disorder taiwan s tailor survey
topic Antidepressants
Depression
Persistence
Stigma
Unmet needs
url https://doi.org/10.1007/s40120-023-00471-y
work_keys_str_mv AT chiamingchang whatdopatientswantinthetreatmentofmajordepressivedisordertaiwanstailorsurvey