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Social Support and Locus of Control as Predictors of Adherence to Antidepressant Medication in an Elderly Population

Received May 3, 2003; revised February 21, 2004; accepted March 24, 2004. From the Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center (CIV,HBB), the Center for the Study of Aging and Human Development, Duke University Medical Center (DCS,HBB), the Department of Psychiatry and Behavioral Science, Duke University Medical Center (DCS,HBB), and the Department of Medicine, Division of General Internal Medicine, Duke University Medical Center (HBB). Please send correspondence and reprint requests to Corrine Voils, Ph.D., Health Services Research and Development, Building 16, Room 70, Durham Veterans Affairs Medical Center (152), 508 Fulton St., Durham, NC 27705. e-mail: voils001{at}mc.duke.edu
© 2005 American Association for Geriatric Psychiatry

Objective: The authors examined whether social support and locus of control (LOC), either individually or jointly, would be associated with subsequent self-reported medication adherence and treatment barriers in a sample of depressed elderly patients. Methods: A group of 85 elderly patients with major depression was enrolled in the Mental Health Clinical Research Center for the Study of Depression in Later Life at Duke University and treated with a standardized algorithm. During the course of the study, participants completed measures of social support and internal locus of control (LOC). A little more than 1 year later, they completed general measures of medication adherence and treatment barriers. Results: Increasing subjective and instrumental social support and non-family interaction were associated with greater adherence among patients high in internal LOC but not among patients low in internal LOC. Less instrumental social support was associated with more treatment barriers among patients low in internal LOC but not among patients high in internal LOC. Conclusion: The relationship between social support and antidepressant medication adherence is moderated by beliefs about control over one’s illness.

Key Words: Depression • Antidepressants • Locus of Control • Social Support

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