Factores relacionados a la adherencia a tratamiento en adolescentes con depresión / Factors associated with treatment adherence in adolescents with depression

ABSTRACT

Introduction: Mood disorders prevalence during adolescence has increased. Unfortunately, the greatest number of diagnosis is not a synonym of treatment success because this depends, among others factors, on the treatment adherence. In fact, mental health research has shown consistently high rates of treatment non-adherence. Nevertheless, the literature has been focused mainly on adult populations, and only a few articles describe adolescent adherence. Objectives: To review the different factors associated with treatment adherence in adolescents with depression and to describe theoretical models that can help improving adherence in this population. Method: Review of current research and adherence theories related to adherence in adolescents with different pathologies, adults with mood disorders and especially in adolescent depression. Conclusion: Cognitive factors related to personal and family beliefs and attitudes towards mental health disorders and medication, biological and psychological factors related to the developmental stage like emotional regulation, self-esteem, self-efficacy and adolescent-parent relationship are very important factors associated to medication adherence in adolescents. The therapeutic relationship might help to improve adherence by shaping these factors, building trust, cooperation, patient and family commitment to behavior change and giving information.

RESUMEN

Desafortunadamente la prevalência de los trastornos depresivos en la adolescencia se ha visto incrementada en los últimos años. Un mayor diagnóstico no conlleva necesariamente a un tratamiento exitoso, debido, entre otros factores, a la pobre adherencia al tratamiento con medicamentos en la adolescencia. De hecho, los estudios en salud mental demuestran que un importante número de pacientes no adhieren a los tratamientos farmacológicos. Sin embargo, estos estudios se centran principalmente en pacientes adultos y pocos en la población infanto juvenil. Nuestro artículo tiene por objetivo conocer de un modo general los factores que están en juego en la adherencia a tratamiento medicamentosos antidepresivo en adolescentes con trastorno del ánimo, y describir un modelo que pueda ayudar a intervenir clínicamente en favor de una mayor adherencia terapéutica.