Kriegshauser Kathryn, Sajatovic Martha, Jenkins Janis H, Cassidy Kristin A, Muzina David, Fattal Omar, Smith Douglas, Singer Beth
Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
J Nerv Ment Dis. 2010 May;198(5):370-2. doi: 10.1097/NMD.0b013e3181da8ef7.
Treatment nonadherence is a leading cause of poor outcomes among populations with bipolar disorder (BD) and is related to subjective experience of illness and treatment. This study examined gender differences in the experience of illness and treatment for those with BD, specifically in regards to treatment adherence. This cross-sectional analysis pooled data from 3 BD studies. A semistructured qualitative instrument, the Subjective Experience of Medication Interview, elicited information on subjective differences in treatment adherence between men and women. Men and women experience comparable levels of stigma and they comparably value lessened irritability and/or impulsivity because of medications. However, men and women differed in fear of weight gain because of medications, value of social support, and self-medication behaviors. Selected differences in subjective illness experience between men and women might be used to inform gender-sensitive approaches to enhance treatment adherence among populations with BD.
治疗依从性差是双相情感障碍(BD)患者预后不良的主要原因,且与疾病及治疗的主观体验相关。本研究考察了BD患者在疾病及治疗体验方面的性别差异,特别是在治疗依从性方面。这项横断面分析汇总了来自3项BD研究的数据。一种半结构化的定性工具,即药物治疗主观体验访谈,收集了关于男性和女性在治疗依从性方面主观差异的信息。男性和女性经历的污名化程度相当,并且他们同样看重因药物治疗而减轻的易怒和/或冲动。然而,男性和女性在因药物治疗而担心体重增加、对社会支持的重视程度以及自我用药行为方面存在差异。男性和女性在主观疾病体验上的特定差异可用于为提高BD患者治疗依从性的性别敏感方法提供信息。