Antidepressant awareness and stigmatizing attitudes toward depression and antidepressants,a comparison between first and sixth-year medical students

Abstract

Background and aim:

Psychiatric disorders and antidepressant usage rates have increased over the years. However, prejudice, self, and public stigma continue to impede patients from receiving appropriate treatment, especially in traditional societies. In this study, the views of first and sixth-year medical students were examined. We aimed to show the potential effect of public information and 6 years of medical education on knowledge and awareness.

Method:

Our target population was first and sixth-year medical students at the Faculty of Medicine at Hacettepe University in Ankara, Turkey, during the semester 2018–2019. For measurement, widely used scales such as the Beck Depression Inventory, Beck Anxiety Inventory were administered. In addition, scales formed specifically by our research team: Sociodemographic information form and Depression and Antidepressant Awareness and Knowledge Scale were used.

Results:

Compared to first-year participants, sixth-year participants had significantly less stigmatizing views on individual statements. The overall stigma score of sixth-year participants was significantly lower (p < .05) than first-year participants. Linear Regression Analysis showed that the only predictor of overall stigma score was the depression score (p < .05, beta = −0.36), which acted as a negative predictor.

Discussion:

Sixth-year participants had higher rates of diagnosed psychiatric illness and psychiatric drug usage. Interestingly, the score was not a predictor of the overall stigma score. However, in the responses to individual statements, we observed an overall increase in knowledge and decreased stigma among the sixth-year participants compared to first-year participants. The effects of medical education on knowledge are significant overall. On the other hand, the level of knowledge and beliefs of our first-year participants, which are similar to the public, show a worrisome situation indicating that broader public education efforts are needed. Our study shows an encouraging perspective, indicating that public awareness campaigns can be very effective in increasing knowledge and decreasing misconceptions.

Keywords

Stigma medical education depression and antidepressant awareness medical students antidepressant usage depression

Introduction

The prevalence of psychiatric disorders has been increasing (Weinberger et al., 2018). The use of antidepressants is also increasing with the rise in the rate of psychiatric disorders, in which depression and anxiety are the most common disorders (Health (UK), 2011; Pratt et al., 2017).

Despite this accretion, the non-changing prejudice (Angermeyer et al., 2009; Mackenzie et al., 2014; Pescosolido et al., 2010), self and public stigma still stand in the way of patients receiving appropriate treatment (Barney et al., 2006; Clement et al., 2015).

The effects of stigma are more clearly seen in traditional societies (Vega et al., 2010). Turkey has a society that can be described as traditional. From 2002 to 2017, it recorded an increase of 21.67% and 25.14% in the diagnoses of depressive and anxiety disorders, respectively. The use of antidepressants has also increased (Ministry of Health of the Republic of Turkey, 2018).

Although many studies analyze public levels of depression and general perceptions of depression, studies focusing on antidepressant knowledge and stigma are very limited (Martinez et al., 2018). To our knowledge, there is not such a study on Turkish society.

Medical students are a high-risk group for depression and anxiety. This group is a particular target considering they are future medical doctors. Medical doctors’ approaches to psychiatric disorders and treatments have been shown to affect the wellbeing of their patients (Saridi et al., 2017). Having information about their approaches to these topics before entering the medical field and examining the effectiveness of medical education in preparing them is of significant importance to patient care.

On this basis, we have hypothesized the following:

Compared to first-year participants, higher levels of depression and anxiety, increased knowledge and awareness of depression and antidepressants reduced stigmatizing attitudes in sixth-year participants.

For the general subject pool, we expect stigmatizing views to decline as the level of depression decreases, familiarity with psychiatric disorders, treatments, and psychiatrists increases. Additionally, to reach semi-similar public attitudes on these topics through first-year participant data, considering that their knowledge and beliefs are shaped only by their experiences in a public setting.

Method

Sample

The target population for this study is first and last (sixth) year students at the Faculty of Medicine of Hacettepe University in Ankara, Turkey. Hacettepe University Medical School is a good cross-section of Turkish medical students as well as the Turkish population, with students coming all over the country, from different regions and different backgrounds.

Data collection was conducted through anonymous questionnaires shared through online platforms that included all the students. They were invited to complete the questionnaire in anon selective manner. We randomly reached out to 206 first-year students out of 436 and 199 sixth-year students out of 488, for a total of 405 students. Of these 405 students, no subject refused to participate in our study. Participants who agreed to take part in the study completed the online questionnaire.

This study is approved by the Non-Invasive Clinical Research Ethics Board of Hacettepe University.

Measures

Sociodemographic Information Form (SDIF) (Supplemental File 1): Formulated by the research team. Includes questions such as gender, family situations, and specified questions regarding the history of personal and familial psychiatric diseases and antidepressant usage.

Beck Depression Inventory (BDI) (Beck et al., 1988): Formed in 1961 by Aron T. Beck, a 21 question self-report scale measuring characteristic attitudes and depression symptoms. The version adopted in Turkish by Hisli was used (Hisli, 1989).

Beck Anxiety Scale (BAS): A measure of anxiety that focuses on somatic symptoms of anxiety. The inventory is administered via self-report and includes assessment of symptoms such as nervousness, dizziness, and inability to relax with a total of 21 items (Beck et al., 1988).

Depression and Antidepressant Knowledge and Awareness scale (DAKAS) (Supplemental File 2): Formulated by our research team. Though there are general knowledge and stigma scales for mental health disorders, we could not find a scale that included specific questions about antidepressants. Although some of the questions on our scale resemble already existing scales, we aimed to focus more on antidepressants while also measuring some specific views on depression. The DAKAS scale has two sections:

- Section-A addressed the stigma aspect of the questionnaire. This section took a scale approach, asking participants to state their views on the statements such as ‘strongly agree/agree/neutral/disagree/strongly disagree’. We aimed to nuance our participants’ general opinions about antidepressants and people who use psychotropic drugs.

- Section-B of the questionnaire focused on statements about general knowledge on depression and antidepressants in particular. The statements are direct sentences that are answered with ‘yes/unsure/no’. This section contained common facts related to these subjects. Though the statements we present in this section are considered fundamental in the medical community, misconceptions and lack of public knowledge are common but are generally not measured by studies.

The overall stigma score is created by combining the first 14 questions in Section-A. The last two items contained commonly used phrases that are important to know participants’ opinions but are not a good measure of stigma and were therefore excluded (items 16 and 17) the exclusion of item 15 will be discussed in the limitation section.

Statistical analysis

Depression scores are calculated with a limit value of 17 points. The comparison of two groups based on their answers to individual statements is carried out by Chi-square analysis. Differences in overall stigma scores are calculated by Mann-Whitney U test. The effects of variables: Age, sex, depression and anxiety scores, having a family member who uses psychiatric drugs, the benefits and side effects of the drugs used by the participant, and the grade of the participant on overall stigma score were calculated using multiple linear regression analysis.

p < .05 is considered statistically significant.

All statistical analyses were performed using IBM SPSS Statistics Premium 23 V program.

Results

The participants’ sociodemographic distribution, their previous experience with psychiatric disorders, treatment and psychiatrist, BDI, and BAS scores are shown in Table 1.

Table 1.

Medical students by sociodemographic characteristics and their responses related to psychiatric diseases.

Characteristics	First year (n = 206)	Sixth year (n = 199)
Age (Mean ± SD), years (p < .05)	19.3 ± 0.6	24.6 + 0.8
Male	74 (36%)	79 (40%)
Female	131 (64%)	119 (60%)
Number of siblings (p > .05) (Mean ± SD),	1.44 ± 1.09	1.54 ± 1.1
Family types (p > .05)
Nuclear	193 (94%)	187 (94%)
Extended	5 (2%)	6 (3%)
Divided	8 (4%)	7 (3%)
Father’s educational level (p > .05)
Lower	12 (6%)	11 (6%)
Middle	31 (15%)	45 (23%)
Higher	162 (79%)	143 (72%)
Mother’s educational level (p > .05)
Lower	33 (16%)	41 (20%)
Middle	50 (24%)	51 (26%)
Higher	123 (60%)	107 (54%)
Smoking (p < .05)
Never	174 (85%)	142 (71%)
Quit	23 (11%)	22 (11%)
Active	9 (4%)	35 (18%)
Having a psychiatric disease (p < .05)	22 (11%)	42 (21%)
Using medicines related to a psychiatric condition (p < .05)	47 (23%)	56 (28%)
Have a relationship with someone that used a psychiatric drug (p < .05)	95 (46%)	100 (50%)
Family having psychiatric diseases (p > .05)	56 (27%)	73 (37%)
Benefit from the drugs (p > .05)	25 (12%)	42 (21%)
Side effects from the drugs (p > 0.05)	12 (6%)	6 (3%)
Beck depression scale (Mean ± SD)	13.42 ± 9.9	1,242 ± 9.4
Maximum score	47	52
Beck anxiety scale (Mean ± SD)	14.7 ± 10.4	1,038 ± 9.1
Maximum score	52	49
Having a session with a psychiatrist (p < .05)	45 (21.8%)	63 (31.7%)
Having a session with a psychologist (p > .05)	60 (29.1%)	59 (29.6%)

Note. SD = standard deviation; n = Number.

About 10.7% (n = 22) of first-year and 21.1% (n = 42) of sixth-year participants reported having/having had a psychiatric disease.

Twenty-seven percent (n = 56) of first-year and 37% (n = 73) of sixth-year participants reported having a family member with psychiatric disease.

Responses to the individual statements in DAKAS are given in Table 2.

Table 2.

Responses to the individual statements in Section A and B.

	Strongly agree + agree	Neutral	Strongly disagree + disagree
SECTION A:
1-Depression is a disease and antidepressant usage is normal (p = .00 Phi = 0.49)
First year	68% (n = 140)	18.9% (n = 39)	13.1% (n = 27)
Sixth year	98% (n = 195)	0.5% (n = 1)	1.5% (n = 3)
2-Happinesses through antidepressant usage are fake happiness (p = .00 Phi = 0.467)
First year	63.5% (n = 131)	20.9% (n = 43)	15.5% (n = 32)
Sixth year	20.6 % (n = 41)	27.6% (n = 55)	51.8% (n = 103)
3-I think the people who use antidepressants are not strong enough (p = .00 Phi = 0.252)
First year	20.8% (n = 43)	25.2% (n = 52)	53.9% (n = 111)
Sixth year	10% (n = 20)	14.1% (n = 28)	75.9% (n = 151)
4-When/If I used antidepressants I shared/would share it with my family (p = .006 Phi = 0.189)
First year	83.5% (n = 172)	6.8% (n = 14)	9.7% (n = 20)
Sixth year	73.4% (n = 146)	14.1% (n = 28)	12.6% (n = 25)
5-When/If I used antidepressants I shared/would share it with my friends (p = .29)
First year	38.3% (n = 79)	37.4% (n = 77)	24.3% (n = 50)
Sixth year	42.2% (n = 84)	29.6% (n = 59)	28.1% (n = 56)
6-Public stigma has a harmful effect on antidepressant drug continuance (p = .04 Phi = 0.157)
First year	70.4% (n = 145)	22.8% (n = 47)	6.8% (n = 14)
Sixth year	78.9% (n = 157)	14.1% (n = 28)	7% (n = 14)
7-Antidepressants are addictive (p = .00 Phi = 0.447)
First year	46.6% (n = 96)	36.9% (n = 76)	16.5% (n = 34)
Sixth year	17.6% (n = 35)	25.6% (n = 51)	56.8% (n = 113)
8-Antidepressants change the personality of the user (p = .00 Phi = 0.425)
First year	46.1% (n = 95)	32.5% (n = 67)	21.3% (n = 44)
Sixth year	17.1% (n = 34)	21.6% (n = 43)	61.2% (n = 122)
9-Psychological problems can be solved by will-power (p = .00 Phi = 0.271)
First year	56.7% (n = 117)	23.3% (n = 48)	19.9% (n = 41)
Sixth year	33.6% (n = 67)	30.2% (n = 60)	36.1% (n = 72)
10-Knowing somebody I know is using antidepressants would make me nervous (p = .00 Phi = 0.275)
First year	10.7% (n = 22)	13.6% (n = 28)	75.7% (n = 156)
Sixth year	2% (n = 4)	3.5% (n = 7)	94.4% (n = 188)
11-Knowing somebody I know is seeing a psychiatrist would make me nervous (p = .18 Phi = 0.171)
First year	7.2% (n = 15)	11.7% (n = 24)	81.1% (n = 167)
Sixth year	4.5% (n = 9)	3.5% (n = 7)	91.9% (n = 183)
12-Depression can be treated solely by psychotherapy (p = .005 Phi = 0.191)
First year	29.1% (n = 60)	43.2% (n = 89)	27.7% (n = 57)
Sixth year	22.1% (n = 44)	32.2% (n = 64)	45.7% (n = 91)
13-I would be anxious to share that I am seeing a psychiatrist with my family (p = .007 Phi = 0.186)
First year	13.1% (n = 27)	8.7% (n = 18)	78.1% (n = 161)
Sixth year	17.1% (n = 34)	14.6% (n = 29)	68.4% (n = 136)
14-I would be anxious to share that I am seeing a psychiatrist with my friends (p = .554)
First year	28.6% (n = 59)	19.9% (n = 41)	51.5% (n = 106)
Sixth year	31.1% (n = 62)	21.1% (n = 42)	47.8% (n = 95)
15-Antidepressants make people numb (p = .00 Phi = 0.435)
First year	54.8% (n = 113)	29.1% (n = 60)	16.1% (n = 33)
Sixth year	20.1% (n = 40)	26.1% (n = 52)	53.8% (n = 107)
16-I think people usually unnecessarily use the phrase ‘I am in depression.’ (p = .086)
First year	87.8% (n = 181)	6.8% (n = 14)	5.4% (n = 11)
Sixth year	93% (n = 185)	2% (n = 4)	5% (n = 10)
17-I think increased prevalence of depression is caused by increased awareness on depression (p = .798)
First year	66.9% (n = 138)	17% (n = 35)	16% (n = 33)
Sixth year	68.9% (n = 137)	18.1% (n = 36)	13.1% (n = 26)
Overall stigma score (formed by questions 1–14). p = .00, U = 11.243. First year: 23. Sixth year: 16
	Yes	Unsure	No
SECTION B:
1-Depression has genetic elements (p = .00 Phi = 0.403)
First year	69.4% (n = 143)	26.2% (n = 54)	4.4% (n = 9)
Sixth year	99% (n = 197)	1% (n = 2)	0% (n = 0)
2-Antidepressants lower the sexual drive (p = .00 Phi = 0.458)
First year	18.4% (n = 38)	71.4% (n = 147)	10.2% (n = 21)
Sixth year	63.3% (n = 126)	31.2% (n = 62)	5.5% (n = 11)
3-Antidepressant usage is more common in females (p = .00 Phi = 0.41)
First year	45.1% (n = 93)	48.5% (n = 100)	6.3% (n = 13)
Sixth year	84.4% (n = 168)	14.1% (n = 28)	1.5% (n = 3)
4-Antidepressants prevent formation of clear thoughts (p = .00 Phi = 0.384)
First year	45.1% (n = 93)	41.3% (n = 85)	13.6% (n = 28)
Sixth year	20.6% (n = 41)	31.7% (n = 63)	47.7% (n = 95)
5-Antidepressants are only used for the treatment of depression (p = .00 Phi = 0.478)
First year	5.8% (n = 12)	40.3% (n = 83)	53.9% (n = 111)
Sixth year	1.5% (n = 3)	3% (n = 6)	95.5% (n = 190)
6-Antidepressants have negative effects on creativity (p = .00 Phi = 0.340)
First year	20.4% (n = 42)	53.9% (n = 111)	25.7% (n = 53)
Sixth year	10.6% (n = 21)	30.2% (n = 60)	59.3% (n = 118)
7-Antidepressants are drugs that require continuous use (p = .00 Phi = 0.446)
First year	51.5% (n = 106)	33% (n = 68)	15.5% (n = 32)
Sixth year	91% (n = 181)	3% (n = 6)	6% (n = 12)
8-Antidepressants show their effects after a short period (p = .00 Phi = 0.557)
First year	16.5% (n = 34)	45.6% (n = 94)	37.9% (n = 78)
Sixth year	6% (n = 12)	3.5% (n = 7)	90.5% (n = 180)
9-All antidepressants aim to increase levels of serotonin (p = .00 Phi = 0.532)
First year	13.1% (n = 27)	50% (n = 103)	36.9% (n = 76)
Sixth year	12.6% (n = 25)	4% (n = 8)	83.4% (n = 166)
10-Antidepressants can’t be purchased without a prescription (p = .00 Phi = 0.278)
First year	68.4% (n = 141)	24.3% (n = 50)	7.3% (n = 15)
Sixth year	68.8% (n = 137)	8.5% (n = 17)	22.6% (n = 45)
11- There is no need for a doctor to consult for the use of plant-based sedatives (p = .03 Phi = 0.172)
First year	4.9% (n = 10)	11.2% (n = 23)	84% (n = 173)
Sixth year	1% (n = 2)	4.5% (n = 9)	94.5% (n = 188)
12- Antidepressants can’t be used in ages 0–6 (p = .00 Phi = 0.389)
First year	45.1% (n = 93)	44.2% (n = 91)	10.7% (n = 22)
Sixth year	24.6% (n = 49)	30.2% (n = 60)	45.2% (n = 90)

The results of the stigma-based statements in Section A show lower stigmatizing attitudes in sixth-year participants. The results of the knowledge-based statements in Section B show higher knowledge among sixth-year participants, as expected.

The overall stigma score of sixth-year participants is significantly lower than first-year participants (p < .05, U = 11.243, mean score = 23.0 for first vs. mean score = 16.0 for sixth-year participants).

There was no significant difference between the two groups in depression scores (p > .05).

In regression analysis, the only predictor for overall stigma score was depression levels with a negative predictor effect (Table 3).

Table 3.

Regression analysis on the predictors of overall stigma score.

Predictors	B	STANDARD ERROR	BETA	t	p
Beck depression scores	–.157	.063	–.360	–2.489	.015
Beck anxiety scores	–.034	.076	–.068	–.450	.654
Age	1.189	.716	.545	1.661	.101
Gender	1.237	1.236	.106	1.001	.320
A family member having used a psychiatric drug	–1.255	1.180	–.109	–1.063	.291
Benefit from the psychiatric drug subject used	.808	1.335	.061	.605	.547
Side effects from the drug subject used	–.283	1.391	–.021	–.204	.839
Class of the subjects: year (1 vs. 6)	–1.005	.761	–.432	–1.320	.191

Discussion

This study measured the depression and antidepressant awareness of first and sixth-year medical students, their level of stigma, and its possible correlating factors such as; the effect of medical education, depression levels, and previous psychiatric experience.

Stigmatization of mental health disorders can lead to social exclusion and discrimination, negatively affect the course of the illness, and impede treatment options (Babić et al., 2017; World Health Organization (WHO)/Europe, 2008). The stigmatizing views of healthcare workers on these topics are critical, given their role in patients’ wellbeing (Saridi et al., 2017). It is therefore essential to measure the stigmatizing views of medical students on these topics. In our study, sixth-year participants had significantly lower overall stigma scores than first-year participants (p < .05, U = 11.243) (mean score of 23 for first and 16 for sixth-year participants). This outcome can be due to their increased knowledge and familiarity with psychiatric patients in medical school (Kingdon, 2004).

Previous work on healthcare workers has shown that, even if they have an overall positive attitude, they can still have significant stigmatizing views (Saridi et al., 2017). However, this was not the case for our participants. Compared to first-year participants, sixth-year participants were significantly more likely to view depression as an illness and antidepressant usage as normal. They had significantly less stigmatizing views, and common misconceptions such as; antidepressants are addictive, and people who use antidepressants are not strong enough (Saridi et al., 2017). In addition, they are less likely to be nervous to know that people around them are taking antidepressants. Interestingly, when we approached the issue in a more personal way: First-year participants were much more open to sharing their antidepressant use and possible psychiatric visits with their families. Given that the majority of the sixth-year participants have been separated from their families for a long time, these findings can be due to the autonomy they have developed throughout their academic life and greater reliance on friends rather than parents for support (Gavin & Furman, 1989). Although there are a few interesting exceptions, sixth-year participants have less stigmatizing attitudes compared to their first-year counterparts. This result might indicate that medical education is generally effective in reducing the stigmatization related to depression and antidepressants.

One of the main ways of combating stigma is educating healthcare workers (WHO, 2001). We observed the effectiveness of medical education on this subject by comparing the levels of knowledge at the entry and completion of medical school. As expected, sixth-year participants had significantly higher levels of knowledge related to depression and antidepressants. Based on our DAKAS questionnaire, sixth-year participants had a significantly higher level of information on expressions related to the genetic basis of depression, the proper use of antidepressants, gender-disparities in this area, and possible side-effects. As far as knowledge on these subjects is concerned, we can affirm that medical education is globally effective. These findings are in line with previous works (Hofmann et al., 2013). Though they had significantly higher levels of knowledge than first-year participants, still a significant proportion (36.7%) of sixth-year participants did not recognize a common side effect of antidepressants (decreased libido). Additionally, a significant percentage (31.2%) did not know that antidepressants are prescription drugs (Social Security Institution of the Republic of Turkey, 2018). These gaps in medical education should be addressed. One of the important outcomes is the lack of knowledge in first-year participants regarding the proper use of antidepressants. Since their information comes from public sources, a situation of public concern may exist. This needs to be addressed given the high rate of non-continuous use of antidepressants and its effects on mental health problems (Yau et al., 2014). Addressing these facts through public awareness campaigns could be useful (Dumesnil & Verger, 2009).

Increased familiarity with psychiatric disorders has been associated with decreased stigmatization (Kingdon, 2004), while in-person experiences can lead to self-stigmatization (Yen et al., 2005). Therefore, we examined our participants’ personal experiences with depression and antidepressants. Depression is an important factor in self-stigmatization. Levels of depression among medical students is an important topic, and previous studies have found high levels of depression among medical students (Rotenstein et al., 2016). As expected, we found a higher level of depression than in the general population (Lim et al., 2018). However, we did not find a significant difference between first and sixth-year participants, as shown in the findings of Bassols et al. (2014).

Sixth-year participants had a significantly higher overall rate of psychiatric disease diagnosis, having a session with a psychiatrist, a prevalence of psychiatric medication use, and a personal relationship with people on psychiatric medication. The joint analysis of psychiatric illness diagnosis and the percentage of psychiatric medication use yielded an interesting result. The percentage of using a psychiatric medication and diagnostics is 71.9% for six-year participants and 61.2% for first-year participants. This indicates possible misuse of these medications, which might be due to the over-the-counter use of psychiatric medications and herbal sedatives (Iza et al., 2019; Miroddi et al., 2013). The substantial increase in personal familiarity might be due to the approximately 5 years age gap between the two groups, especially considering that these 5 years are below the 25-year threshold, since 75% of patients with common mental health problems have their onset before the age of 25 (Kessler et al., 2007). Another contributing factor can be the effects of medical school on mental health (Rotenstein et al., 2016).

Previous works on the Western population show that patients on antidepressants have common negative attitudes and misconceptions about these topics (Hoencamp et al., 2002). Additionally, previous studies have established the binding effect of self-stigmatization (Yen et al., 2005). Based on these studies, one would expect that self-stigmatization would have negative effects on the overall stigma scores of depressed participants. Interestingly in our regression analysis, the only predictor of the overall stigma score was the depression score. Surprisingly, this is a negative predictor. However, this surprising outcome is not without precedent. In societies described as more traditional, previous studies show more positive attitudes toward antidepressants. This might be due to seeing oneself as a member of society, and therefore feeling the need to adapt to the given society (Jacob et al., 2015), leading to the use of antidepressants as a means of adaptation. The grade was not a predictor of the overall stigma score, based on regression analysis. This outcome was unexpected, given that we found significant differences between the two groups in terms of individual statements and overall stigma score. Sixth-year participants were more knowledgeable and had significantly less stigmatizing opinions, favoring the positive effect of medical education in this regard. The surprising outcome can be due to increased familiarity. Sixth-year participants had a significantly higher level of personal experience with the topics. Being more familiar with both personal and environmental aspects may have led to less stigmatization.

Limitations

One of the limitations of our study is not using the follow-up method. However, this method would be time-consuming, and it was not possible to find the same participants. Thus, a cross-sectional study was carried out instead. Another limitation is not having the entire first and sixth-year students as participants. Although we shared the survey in social media groups that included all first and sixth-year students since this is a volunteer-based survey, not all students in these groups participate in our study. As indicated in the methods, item 15 (‘Antidepressants make people numb.’) in Section A of DAKAS was excluded from the overall stigma score. The translation problem was the main reason. Due to a wording issue, the Turkish version of the statement could have been interpreted as both emotional numbness and a feeling of narcosis, which could have affected the results. Finally, although we have applied the existing scales such as BDI in the literature, there is no specific and targeted scale that measures knowledge and stigma about antidepressants, so we had to prepare DAKAS. It was essential to ask these questions in order to measure particular views on depression- antidepressants and to understand the effects of medical education on depression-antidepressant knowledge and stigma.

Conclusion

Our findings show this: Increased levels of medical education, better knowledge of mental health problems, and patients lead to lower levels of stigmatization. Increased familiarity is one of the most important ways of decreasing stigma. There is an apparent effect of medical education on the level of knowledge and stigma. While there is information that needs to be emphasized more, the medical curriculum gives its students the notion of seeing mental health problems as an illness, their victims as patients, and seeing antidepressants as a method of treatment. Moreover, since these notions can be learned through education, public education programs, and awareness campaigns might help in changing stigmatizing views.

Supplemental Material

sj-pdf-1-isp-10.1177_0020764020985545 – Supplemental material for Antidepressant awareness and stigmatizing attitudes toward depression and antidepressants, a comparison between first and sixth-year medical students

Supplemental material, sj-pdf-1-isp-10.1177_0020764020985545 for Antidepressant awareness and stigmatizing attitudes toward depression and antidepressants, a comparison between first and sixth-year medical students by Ayşe Derin Nalçakan, Ezgi Aysu Şahin, Oguz Kaan Yalcinkaya and Sertac Ak in International Journal of Social Psychiatry

Supplemental Material

sj-pdf-2-isp-10.1177_0020764020985545 – Supplemental material for Antidepressant awareness and stigmatizing attitudes toward depression and antidepressants, a comparison between first and sixth-year medical students

Supplemental material, sj-pdf-2-isp-10.1177_0020764020985545 for Antidepressant awareness and stigmatizing attitudes toward depression and antidepressants, a comparison between first and sixth-year medical students by Ayşe Derin Nalçakan, Ezgi Aysu Şahin, Oguz Kaan Yalcinkaya and Sertac Ak in International Journal of Social Psychiatry

Footnotes

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iDs

Ayşe Derin Nalçakan

Ezgi Aysu Şahin

Oguz Kaan Yalcinkaya

Supplemental material

Supplemental material for this article is available online.

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