Beliefs about the biological nature of mental disorders and how they affect antidepressant use and withdrawal

Long-term treatment with antidepressants is increasingly prevalent and evidence suggests beliefs about the nature of mental health conditions affect people's attitudes to antidepressant treatment. However, possible confounding effects of the severity of their condition have not been addressed. The current study aimed to explore effects of believing in the biological nature of mental health conditions on people's use of, and attitudes towards antidepressant treatment. It consisted of a survey of people attending a public therapy service for people with anxiety and depressive disorders in the UK who were taking or had taken antidepressants. A total of 497 people responded. 57 % endorsed at least one statement about the biological aetiology of their condition and 66 % thought their condition related to life events. People with biological beliefs had used antidepressants for longer than those without (median 12 vs 6 months p = 0.005, Mann-Whitney-U) and they were less likely to have attempted to stop their antidepressant (58.5 % vs 67.6 %, X² = 4.3, d. f. 1, p = 0.04). They were also more likely to believe that antidepressants had improved their condition and that they could not cope without them. The severity of depressive and anxiety symptoms was not associated with holding biological beliefs. Among those who had attempted to stop their antidepressant, holding biological beliefs was not associated with more common or more severe withdrawal symptoms, but longer duration of use was related to more severe withdrawal. Education to correct unsupported beliefs about the aetiology of mental disorders may help reduce unnecessary long-term use of antidepressants.