Living with psychotropic drugs: A community photovoice study in people with high treatment adherence in Southeastern Spain

Francisco Martínez-Granados PhD in Health Sciences. Head of Pharmacy Unit. Centro psiquiátrico socio-asistencial Doctor Esquerdo, Alicante, Spain. , Erica Briones-Vozmediano PhD in Public Health. Associate Professor in the Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, Universidad de Lleida. Research Group in Health, Education and Culture (GESEC), Universidad de Lleida. Grup de Recerca en Cures en Salut (GRECS), Institut de Recerca Biomèdica (IRB), Lleida, Spain. image/svg+xml , Elena Ronda PhD in Medicine. Professor of Preventive Medicine and Public Health, Area of Preventive Medicine and Public Health, Universidad de Alicante, Alicante, Spain. Area of Epidemiology and Public Health, Centro de Investigación Biomédica en Red (CIBERESP), Madrid, Spain. image/svg+xml
Received: 13 June 2024, Accepted: 10 September 2024, Published: 29 October 2024 Open Access
Abstract views
284
Metrics Loading ...

Abstract


Adherence to psychopharmacological treatment essentially involves a process of meaning-making. The objective of this study was to explore the experience of people undergoing chronic psychiatric treatment from the patients’ perspective. In 2018, using the photovoice methodology, four sessions were conducted with the participation of 11 individuals from a community school in a socially marginalized neighborhood of a southeastern Spanish city, some of whom were also users of a social rehabilitation and integration center and a day center. Participants took and selected 41 photographs under the premise: “Photograph your experience regarding health and medication.” A categorization of the emerging narratives was carried out during a dialogical session between participants and researchers, which was recorded for subsequent transcription and analysis. The experiences were divided into two major symbolic themes that seek to give therapeutic meaning to medication: one of conflict and the other of motivation.

Full-text of the article is available for this language: Español.


References


1. Osterberg L, Blaschke T. Adherence to medication. The New England Journal of Medicine. 2005;353(5):487-497.
Crossref | PubMed

2. Tranulis C, Goff D, Henderson DC, Freudenreich O. Becoming adherent to antipsychotics: a qualitative study of treatment-experienced schizophrenia patients. Psychiatric services (Washington, D.C.). 2011;62(8):888-892.
Crossref | PubMed

3. Fenton WS, Blyler CR, Heinssen RK. Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophrenia Bulletin. 1997;23(4):637-651.
Crossref | PubMed

4. Sajatovic M, Levin J, Fuentes-Casiano E, Cassidy KA, Tatsuoka C, Jenkins JH. Illness experience and reasons for nonadherence among individuals with bipolar disorder who are poorly adherent with medication. Comprehensive Psychiatry. 2011;52(3):280-287.
Crossref | PubMed

5. Taibanguay N, Chaiamnuay S, Asavatanabodee P, Narongroeknawin P. The effects of education on patient adherence to medication. Evidence Based Healthc Public Health. 2005;9(6):398-404.
Crossref

6. Zygmunt A, Olfson M, Boyer CA, Mechanic D. Interventions to improve medication adherence in schizophrenia. American Journal of Psychiatry. 2002;159(10):1653-1664.
Crossref | PubMed

7. Fischel T, Krivoy A, Kotlarov M, Zemishlany Z, Loebstein O, Jacoby H, et al. The interaction of subjective experience and attitudes towards specific antipsychotic-related adverse effects in schizophrenia patients. European Psychiatry Journal of the European Psychatic Association. 2013;28(6):340-343.
Crossref | PubMed

8. Hellewell JSE. Patients’ subjective experiences of antipsychotics: clinical relevance. CNS Drugs. 2002;16(7):457-471.
Crossref | PubMed

9. Rossi A, Arduini L, Stratta P, Pallanti S. Subjective experience and subjective response to neuroleptics in schizophrenia. Comprehensive Psychiatry. 2000;41(6):446-449.
Crossref | PubMed

10. De Las Cuevas C, Motuca M, Baptista T, de Leon J. Skepticism and pharmacophobia toward medication may negatively impact adherence to psychiatric medications: a comparison among outpatient samples recruited in Spain, Argentina, and Venezuela. Patient Preference and Adherence. 2018;12:301-310.
Crossref | PubMed

11. Gatti ME, Jacobson KL, Gazmararian JA, Schmotzer B, Kripalani S. Relationships between beliefs about medications and adherence. American journal of health-system pharmacy. 2009;66(7):657-664.
Crossref | PubMed

12. Shoemaker SJ, Ramalho de Oliveira D. Understanding the meaning of medications for patients: the medication experience. Pharmacy World & Science. 2008;30(1):86-91.
Crossref | PubMed

13. Moncrieff J, Cohen D, Mason JP. The subjective experience of taking antipsychotic medication: a content analysis of Internet data. Acta Psychiatrica Scandinavica. 2009;120(2):102-111.
Crossref | PubMed

14. Geertz C. La interpretación de las culturas. Barcelona: GEDISA; 2003.

15. Turner V. La selva de los símbolos. Aspectos del ritual ndembu. Madrid: Siglo XXI Editores; 2020.

16. Velasco HM (comp.). Lecturas de antropología social y cultural. La cultura y las culturas. Madrid: Universidad Nacional de Educación a Distancia (UNED); 2010.

17. Hall S, Evans J, Nixon S. Representation: cultural representations and signifying practices. Sage, The Open University; 1997.

18. Werremeyer A, Skoy E, Aalgaard Kelly G. Use of Photovoice to Understand the Experience of Taking Psychotropic Medications. Qualitative Health Research. 2017;27(13):1959-1969.
Crossref | PubMed

19. Catalani C, Minkler M. Photovoice: A Review of the Literature in Health and Public Health. Health Education & Behavior. 2010;37(3):424-451.
Crossref | PubMed

20. Wang C, Burris MA. Photovoice: concept, methodology and use for participatory needs assessment. Health Education & Behavior. 1997;24(3):369-387.
Crossref | PubMed

21. Drainoni ML, Childs E, Biello KB, Biancarelli DL, Edeza A, Salhaney P, et al. “We don’t get much of a voice about anything”: perspectives on photovoice among people who inject drugs. Harm Reduction Journal. 2019;16(1):61.
Crossref | PubMed

22. Halvorsrud K, Rhodes J, Webster GM, Francis J, Haarmans M, Dawkins N, et al. Photovoice as a promising public engagement approach: capturing and communicating ethnic minority people’s lived experiences of severe mental illness and its treatment. BMJ Open Quality. 2019;8(4):e000665.
Crossref | PubMed

23. Han CS, Oliffe JL. Photovoice in mental illness research: A review and recommendations. Health. 2016;20(2):110-126.
Crossref | PubMed

24. Moretti V, Brunetti C, Candaten A, Cannavò D, Manfredi M, Maserati M, et al. Take a picture! The role of visual methods in understanding psychiatric patient’s everyday life. Acta Biomédice. 2021;92(S2):e2021028.

25. Nelson E, Werremeyer A, Kelly GA, Skoy E. Self-stigma of antidepressant users through secondary analysis of PhotoVoice data. The Mental Health Clinician. 2018;8(5):214-221.
Crossref | PubMed

26. Beresford P, Rose D. Decolonising global mental health: The role of Mad Studies. Global Mental Health. 2023;10:e30.
Crossref | PubMed

27. Asamblea General de la ONU. Informe del Relator Especial sobre el derecho de toda persona al disfrute del más alto nivel posible de salud física y mental [Internet]. (Consejo de Derechos Humanos). Report No.: A/HRC/35/21; 2017 [citado 27 ago 2024]. Disponible en: https://tinyurl.com/4w2npwc3.

28. Avarca CA de C, Serrano-Miguel M, Vicentin MCG, Martínez-Hernáez Á. El modelo GAM (Gestión Autónoma de la Medicación) como generador de autonomía en salud mental. Interface - Comunicação, Saúde, Educação. 2022;26:e210506.
Crossref

29. Serrano-Miguel M, Pié-Balaguer A, Martínez-Hernáez A. Guía para la gestión colaborativa de la medicación en salud mental. Universitat Rovira i Virgili i Universitat Oberta de Catalunya; 2020.

30. Raboch J, Kalisová L, Nawka A, Kitzlerová E, Onchev G, Karastergiou A, et al. Use of coercive measures during involuntary hospitalization: findings from ten European countries. Psychiatrycs Service (Washintong, DC). 2010;61(10):1012-1017.
Crossref | PubMed

31. Sailas E, Fenton M. Seclusion and restraint for people with serious mental illnesses. The Cochrane Database of Systematic Reviews. 2000;2000(2):CD001163.
Crossref | PubMed

32. Vidal MCU, Balaguer AP, Coll-Florit M, Encuentra EH i, Climent S. Orgullo loco y metáforas para una disidencia: un análisis lingüístico y simbólico. Salud Colectiva. 2020;16:e2886-e2886.
Crossref | PubMed

33. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Medical Care. 1986;24(1):67-74.
Crossref | PubMed

34. Escohotado A. Historia general de las drogas. Madrid: Espasa Calpe; 2002.

35. Smith R. The trouble with medical journals. Journal of the Royal Society of Medicine. 2006;99(3):115-119.
Crossref

36. Moynihan R, Heath I, Henry D. Selling sickness: the pharmaceutical industry and disease mongering. BMJ. 2002;324(7342):886-891.
Crossref | PubMed

37. Cosgrove L, Krimsky S, Wheeler EE, Kaitz J, Greenspan SB, DiPentima NL. Tripartite conflicts of interest and high stakes patent extensions in the DSM-5. Psychotherapy and Psychosomatics. 2014;83(2):106-113.
Crossref | PubMed

38. Moncrieff J. The myth of the chemical cure: A critique of psychiatric drug treatment. Macmillan Children’s Books; 2007.
Crossref

39. Mosher L, Gosden R, Beder S. Las empresas farmacéuticas y la esquizofrenia. En: Modelos de locura: Aproximaciones psicológicas, sociales y biológicas a la esquizofrenia. Barcelona: Herder; 2006.

40. Summerfield D. How scientifically valid is the knowledge base of global mental health? BMJ. 2008;336(7651):992-994.
Crossref | PubMed

41. Moncrieff J. An Alternative Approach to Drug Treatment in Psychiatry. En: Steingard S, editor. Critical Psychiatry. Cham: Springer International Publishing; 2019. p. 97-111.
Crossref

42. Martínez Granados F. Crítica a la práctica psicofarmacológica a partir de la Ética de Spinoza. Revista de la Asociación Española de Neuropsiquiatría. 2024;44(145):191-211.

43. Whitaker R. Mad in America: Bad science, bad medicine, and the enduring mistreatment of the mentally ill. Basic Books; 2003.

44. Cosgrove L, Krimsky S. A comparison of DSM-IV and DSM-5 panel members’ financial associations with industry: A pernicious problem persists. PLoS Medicine. 2012;9(3):e1001190.
Crossref | PubMed

45. Martínez Marzoa F. La filosofía de El Capital. Madrid: Abada Editores; 2018.

46. Martínez Granados F. La adherencia farmacoterapéutica: de la obediencia al conocimiento, la ética y la cultura. (Con)textos: revista d’antropologia i investigació social. 2021;(9):1-18.

47. Moncrieff J. Does antipsychotic withdrawal provoke psychosis? Review of the literature on rapid onset psychosis (supersensitivity psychosis) and withdrawal-related relapse. Acta Psychiatrica Scandinavian. 2006;114(1):3-13.
Crossref | PubMed

48. Moncrieff J. Why is it so difficult to stop psychiatric drug treatment? Medical Hypotheses. 2006;67(3):517-523.
Crossref | PubMed

49. Moncrieff J, Lewis G, Freemantle N, Johnson S, Barnes TRE, Morant N, et al. Randomised controlled trial of gradual antipsychotic reduction and discontinuation in people with schizophrenia and related disorders: the RADAR trial (Research into Antipsychotic Discontinuation and Reduction). BMJ Open. 2019;9(11):e030912.
Crossref | PubMed

50. Parada TC. Subjetividad y autonomía: significados y narrativas sobre la discontinuación de fármacos psiquiátricos. Salud Colectiva. 2018;14(3):513-529.
Crossref | PubMed

51. Cooke A. Comprender la psicosis y la esquizofrenia. ¿Por qué a veces las personas oyen voces, creen cosas que a otros les parecen extrañas, o parecen estar fuera de la realidad, y qué es lo que puede ayudarles?. Division of Clinical Psychology (The British Psychological Society); 2014.

52. Kamaradova D, Latalova K, Prasko J, Kubinek R, Vrbova K, Mainerova B, et al. Connection between self-stigma, adherence to treatment, and discontinuation of medication. Patient Prefer Adherence. 2016;10:1289-1298.
Crossref | PubMed

53. Schatzberg AF, Nemeroff CB. The American Psychiatric Association Publishing Textbook of Psychopharmacology. Arlington: American Psiquiatric Association Publishing; 2017.
Crossref

54. Seeman P. All roads to schizophrenia lead to dopamine supersensitivity and elevated dopamine D2(high) receptors. CNS Neuroscience & Therapeutics. 2011;17(2):118-132.
Crossref | PubMed

55. Samaha AN, Seeman P, Stewart J, Rajabi H, Kapur S. «Breakthrough» dopamine supersensitivity during ongoing antipsychotic treatment leads to treatment failure over time. The Journal of Neuroscience. 2007;27(11):2979-2986.
Crossref | PubMed

56. Martínez Granados F, Moñino Martínez C, Pol Yanguas E, Ivorra Cano JM, Villar Malpica JL. Análisis de la correlación entre la calidad de la prescripción de antipsicóticos y el estado clínico en pacientes con esquizofrenia. Farmacia Hospitalaria. 2005;29(2):95-103.
Crossref | PubMed

57. Werremeyer AB, Aalgaard-Kelly G, Skoy E. Using Photovoice to explore patients’ experiences with mental health medication: A pilot study. The Mental Health Clinicial. 2016;6(3):142-153.
Crossref | PubMed

58. Lincoln YS, Guba EG. Naturalistic Inquiry. SAGE; 1985.
Crossref