Beliefs about depression and its treatments: Associated variables and the influence of beliefs on adherence to treatment | Revista de Psiquiatría y Salud Mental (English Edition)

array:24 ["pii" => "S2173505012000957" "issn" => "21735050" "doi" => "10.1016/j.rpsmen.2012.08.002" "estado" => "S300" "fechaPublicacion" => "2013-04-01" "aid" => "187" "copyright" => "SEP y SEPB" "copyrightAnyo" => "2012" "documento" => "article" "crossmark" => 0 "subdocumento" => "ssu" "cita" => "Rev Psiquiatr Salud Ment. 2013;6:86-92" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3154 "formatos" => array:3 [ "EPUB" => 21 "HTML" => 2360 "PDF" => 773 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S1888989112001693" "issn" => "18889891" "doi" => "10.1016/j.rpsm.2012.08.001" "estado" => "S300" "fechaPublicacion" => "2013-04-01" "aid" => "187" "copyright" => "SEP y SEPB" "documento" => "article" "crossmark" => 0 "subdocumento" => "ssu" "cita" => "Rev Psiquiatr Salud Ment. 2013;6:86-92" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 7058 "formatos" => array:3 [ "EPUB" => 9 "HTML" => 5298 "PDF" => 1751 ] ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "Revisión" "titulo" => "Creencias sobre la depresión y sus tratamientos: variables asociadas e influencia de las creencias en la adherencia" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "86" "paginaFinal" => "92" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Beliefs about depression and its treatments: Associated variables and the influence of beliefs on adherence to treatment" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Francisco Acosta, Luciano Rodríguez, Beatriz Cabrera" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Francisco" "apellidos" => "Acosta" ] 1 => array:2 [ "nombre" => "Luciano" "apellidos" => "Rodríguez" ] 2 => array:2 [ "nombre" => "Beatriz" "apellidos" => "Cabrera" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173505012000957" "doi" => "10.1016/j.rpsmen.2012.08.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173505012000957?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888989112001693?idApp=UINPBA00004N" "url" => "/18889891/0000000600000002/v1_201305031459/S1888989112001693/v1_201305031459/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173505012000970" "issn" => "21735050" "doi" => "10.1016/j.rpsmen.2012.09.002" "estado" => "S300" "fechaPublicacion" => "2013-04-01" "aid" => "188" "copyright" => "SEP y SEPB" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Rev Psiquiatr Salud Ment. 2013;6:93-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2143 "formatos" => array:3 [ "EPUB" => 10 "HTML" => 1665 "PDF" => 468 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "Scientific letter" "titulo" => "Treatment of acute mania with methylphenidate: Therapeutic approach based on a new pathophysiological model" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "93" "paginaFinal" => "94" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento de la manía aguda con metilfenidato: propuesta terapéutica basada en un nuevo modelo fisiopatológico" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Pilar López-García, Ulrich Hegerl" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Pilar" "apellidos" => "López-García" ] 1 => array:2 [ "nombre" => "Ulrich" "apellidos" => "Hegerl" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S188898911200184X" "doi" => "10.1016/j.rpsm.2012.09.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S188898911200184X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173505012000970?idApp=UINPBA00004N" "url" => "/21735050/0000000600000002/v1_201305031504/S2173505012000970/v1_201305031504/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173505012000945" "issn" => "21735050" "doi" => "10.1016/j.rpsmen.2012.07.002" "estado" => "S300" "fechaPublicacion" => "2013-04-01" "aid" => "183" "copyright" => "SEP y SEPB" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Rev Psiquiatr Salud Ment. 2013;6:80-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1908 "formatos" => array:3 [ "EPUB" => 9 "HTML" => 1463 "PDF" => 436 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Brief report" "titulo" => "Burden of disease in adolescents and young people in Spain" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "80" "paginaFinal" => "85" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Carga de enfermedad en adolescentes y jóvenes en España" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ferrán Catalá-López, Ricard Gènova-Maleras, Elena Álvarez-Martín, Nerea Fernández de Larrea-Baz, Consuelo Morant-Ginestar" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Ferrán" "apellidos" => "Catalá-López" ] 1 => array:2 [ "nombre" => "Ricard" "apellidos" => "Gènova-Maleras" ] 2 => array:2 [ "nombre" => "Elena" "apellidos" => "Álvarez-Martín" ] 3 => array:2 [ "nombre" => "Nerea" "apellidos" => "Fernández de Larrea-Baz" ] 4 => array:2 [ "nombre" => "Consuelo" "apellidos" => "Morant-Ginestar" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1888989112001498" "doi" => "10.1016/j.rpsm.2012.07.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888989112001498?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173505012000945?idApp=UINPBA00004N" "url" => "/21735050/0000000600000002/v1_201305031504/S2173505012000945/v1_201305031504/en/main.assets" ] "en" => array:18 [ "idiomaDefecto" => true "cabecera" => "Review article" "titulo" => "Beliefs about depression and its treatments: Associated variables and the influence of beliefs on adherence to treatment" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "86" "paginaFinal" => "92" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Francisco Acosta, Luciano Rodríguez, Beatriz Cabrera" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Francisco" "apellidos" => "Acosta" "email" => array:1 [ 0 => "fjacostaartiles@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "¿" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Luciano" "apellidos" => "Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Beatriz" "apellidos" => "Cabrera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Salud Mental, Dirección General de Programas Asistenciales, Gran Canaria, Canarias, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Psiquiatría, Hospital Universitario de Gran Canaria Dr. Negrín, Gran Canaria, Canarias, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Creencias sobre la depresión y sus tratamientos: variables asociadas e influencia de las creencias en la adherencia" ] ] "textoCompleto" => "IntroductionDepression is one of the most prevalent and disabling mental disorders in the general population, with substantial consequences at the individual, family and socioeconomic levels. Adherence to treatment is a key factor in recovery for more favourable clinical results later.<a class="elsevierStyleCrossRefs" href="#bib0005">1,2</a> For their part, one's beliefs about depression and treatment (both psychopharmacological and psychotherapeutic) have been considered as the main variables associated with adherence to antidepressant treatment. In turn, there are multiple determining factors for these beliefs, including sociodemographic and cultural factors and those about the illness itself, among others.<a class="elsevierStyleCrossRef" href="#bib0015">3</a>This review addresses the areas of adherence to antidepressant treatment and psychotherapy, the influence that beliefs and attitudes towards treatment have on adherence, beliefs and attitudes towards depression, psychopharmacological treatment and psychotherapy, as well as its evaluation and limitations in the studies available. It also identifies the most relevant findings of the variables related to these beliefs, although not as an independent section.Adherence to antidepressant treatmentIt has been estimated that non-adherence to antidepressant medication oscillates between 30% and 60%.<a class="elsevierStyleCrossRef" href="#bib0020">4</a> Among its consequences are increased rate of relapses and recurrences.<a class="elsevierStyleCrossRefs" href="#bib0005">1,2</a> Despite the fact that 49–84% of the patients perceive the need for antidepressant treatment,<a class="elsevierStyleCrossRef" href="#bib0015">3</a> 1/3 abandon treatment 3 months after feeling better.<a class="elsevierStyleCrossRef" href="#bib0025">5</a> At 6 months, the rate of non-adherence reaches 55%.<a class="elsevierStyleCrossRef" href="#bib0030">6</a> Strikingly, only 1–2% of publications dedicated to the treatment of affective disorders explore the factors associated with non-adherence to medication.<a class="elsevierStyleCrossRef" href="#bib0035">7</a>Non-adherence is a multifactorial phenomenon. The risk factors have been grouped into several categories: those related to the patient, illness, medication, medical and health care, and family and society.<a class="elsevierStyleCrossRef" href="#bib0040">8</a> The most established factors have been the patient's attitudes and beliefs about health (including the stigma attached to depression), the patient's and family's attitudes and beliefs about depression and medication, a poor doctor–patient or psychotherapist–patient relationship and previous non-adherence. Other factors mentioned are side effects of the medication, lower education and economic level (especially in the early stages of treatment), not being married, depression itself, forgetfulness, certain personality traits, substance abuse, medical comorbidity and somatoform symptoms.<a class="elsevierStyleCrossRefs" href="#bib0035">7,8</a> Psychoeducation<a class="elsevierStyleCrossRef" href="#bib0045">9</a> and decision-making in conjunction with the patient<a class="elsevierStyleCrossRef" href="#bib0050">10</a> are relevant factors for improving adherence. For its part, employment has been associated with a larger social network and a better attitude towards drug treatment and adherence to it.<a class="elsevierStyleCrossRef" href="#bib0055">11</a>Both the degree of non-adherence and the risk factors may vary according to the evolutionary moment. Early discontinuation is associated with secondary effects and the perception of medication as ineffective. Patients in the maintenance phase (by definition they are less depressed) reduce their adherence with clinical improvement. Furthermore, they tend to believe that they do not need medication any more or they are less willing to continue tolerating the previously acceptable adverse effects, such as sexual dysfunction.<a class="elsevierStyleCrossRef" href="#bib0060">12</a> For its part, adherence is greater in cases of more severe symptoms, while it predisposes patients not to start treatment in milder cases.<a class="elsevierStyleCrossRef" href="#bib0065">13</a>Adherence to psychotherapyNon-adherence is a prevalent phenomenon in the psychotherapeutic process.<a class="elsevierStyleCrossRef" href="#bib0070">14</a> According to meta-analysis, it falls between 35%<a class="elsevierStyleCrossRef" href="#bib0075">15</a> and 47%<a class="elsevierStyleCrossRef" href="#bib0070">14</a> and may exceed 60% when non-attendance to the first contact appointment is evaluated.<a class="elsevierStyleCrossRefs" href="#bib0080">16,17</a> In other studies, only 11% completed therapy<a class="elsevierStyleCrossRef" href="#bib0090">18</a> and only 10% reached the tenth session.<a class="elsevierStyleCrossRef" href="#bib0095">19</a> Non-adherence occurs in all disorders, treatment programmes and therapy types and formats.<a class="elsevierStyleCrossRef" href="#bib0100">20</a>There are very few studies evaluating adherence in psychotherapy.<a class="elsevierStyleCrossRef" href="#bib0035">7</a> Therefore, there are barely any studies on depression<a class="elsevierStyleCrossRef" href="#bib0105">21</a> and most have focused on socio-demographic characteristics.Findings on risk factors for non-adherence have been inconclusive. Multiple factors have been encompassed in several areas: patient, therapeutic relationship, context, type of psychotherapy and expectations for therapy.<a class="elsevierStyleCrossRef" href="#bib0110">22</a> However, there is unanimity that the therapeutic relationship, and especially the therapeutic alliance, is a fundamental aspect for adherence; it is also essential, although not itself curative, for the success of psychotherapy.<a class="elsevierStyleCrossRefs" href="#bib0115">23,24</a>How beliefs and attitudes towards treatment influence adherenceNegative beliefs about medication<a class="elsevierStyleCrossRef" href="#bib0035">7</a> and illness<a class="elsevierStyleCrossRef" href="#bib0125">25</a> are an important factor for non-adherence. Positive attitudes regarding antidepressants are associated with more active use of mental health services.<a class="elsevierStyleCrossRef" href="#bib0130">26</a> A positive attitude towards drug therapy was the main predictor of adherence in a prospective study.<a class="elsevierStyleCrossRef" href="#bib0135">27</a> In patients with depression, specific beliefs (such as “my health depends on antidepressants”) and less concern about being dependent on this medication have been strongly associated with adherence. Beliefs that drugs cause pain that they are over-prescribed the experience of adverse effects and greater severity of depression were associated with poor adherence.<a class="elsevierStyleCrossRef" href="#bib0140">28</a> The main negative belief found consistently regarding antidepressants was the belief that they can cause addiction.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> Other authors did not find an association between the belief that treatment is necessary and better adherence, but an association was found between concern about the medication and non-adherence.<a class="elsevierStyleCrossRef" href="#bib0145">29</a> Positive attitudes towards antidepressants have been associated with the use of antidepressants, with patient education about antidepressants being a mediating variable between the 2.<a class="elsevierStyleCrossRef" href="#bib0150">30</a> In this vein, increased adherence was found in clinical trials in patients receiving advice on treatment, compared to those who did not.<a class="elsevierStyleCrossRef" href="#bib0155">31</a> Furthermore, positive changes in beliefs about antidepressants have been found in patients who received an intervention programme that included psychoeducation about antidepressant treatment vs the standard systematic follow-up.<a class="elsevierStyleCrossRef" href="#bib0160">32</a> Patients with greater knowledge on depression and antidepressants and lower perceived stigma adhered better to treatment.<a class="elsevierStyleCrossRef" href="#bib0165">33</a> One of the difficulties in studying stigma and its influence on adherence is differentiating between the stigma associated with antidepressant treatment and that related to depression.<a class="elsevierStyleCrossRef" href="#bib0170">34</a> The following beliefs have been identified as components of the stigma in patients with depression: that others think the person to be responsible for suffering depression that being near people with depression is not desirable and that these people might constitute a danger.<a class="elsevierStyleCrossRef" href="#bib0175">35</a>Different models have attempted to give coherent explanatory support to the complex interactions among the various factors involved.Horne's theoretical model distinguishes between beliefs about medication in general and beliefs about what is specifically prescribed. The latter includes 2 constructs: perceived need for medication (necessity) and perceived potential for medication to cause problems (concern).<a class="elsevierStyleCrossRef" href="#bib0180">36</a> Beliefs about medication in general seem to be most relevant for adherence at the start of treatment.<a class="elsevierStyleCrossRef" href="#bib0185">37</a> In this acute phase, changes in beliefs about antidepressants occur. Perceptions become more pro-adherence as patients continue to have experience with the treatment; perception of the need for treatment increases and that of harmful potential of drugs weakens. Beliefs in the danger of antidepressants predict the later appearance of side effects, while the occurrence of side effects reinforces the belief of danger.<a class="elsevierStyleCrossRef" href="#bib0190">38</a> In the maintenance phase, the different degrees of adherence are explained by the balance between the perceptions of need and potential harm; adherence is lower when the perceived harm exceeds the perceived need, and higher when the perceived need exceeds the perceived harm.<a class="elsevierStyleCrossRef" href="#bib0060">12</a>The Health Belief Model postulates that the main determinants of the search for treatment and adherence are beliefs about susceptibility to a health problem and its severity, treatment effectiveness, benefits perceived and treatment barriers.<a class="elsevierStyleCrossRef" href="#bib0195">39</a> Such beliefs may be especially important in mental disorders, which are often stigmatized and not well understood.<a class="elsevierStyleCrossRef" href="#bib0200">40</a> Adherence is correlated with the patient's beliefs about the severity of the disease to be treated or prevented.<a class="elsevierStyleCrossRef" href="#bib0125">25</a> Four states of subjective positioning have been identified according to the “perceived need” and “perception of harm” in depressed patients: sceptical (those that consider the need for treatment to be low and have high concern for harm related to treatment), ambivalent (those that perceive high need and worry), indifferent (those that assess both the need and concern about harm to be low) and accepting (those that perceive a high necessity and low worry).<a class="elsevierStyleCrossRef" href="#bib0060">12</a>Beliefs and attitudes towards depression, medication and psychotherapyBeliefs about depressionThe areas studied have been the aetiology of depression, the usefulness of treatments, the search for help and the perceived stigma. Beliefs about the causes of depression are mostly non-biological, psychological or environmental.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> However, while the general population and patients affected by milder depressive disorders refer to causes or external factors (reactive to interpersonal difficulties and stress), the more serious patients tend to allude to a biological aetiology and put more trust in drug treatment. For their part, people who suffer from depression tend to have more positive beliefs about treatment than do healthy people.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> The most commonly mentioned causes of depression were stress associated with work, followed by personality and family situation, with only 3.6% of the respondents giving biological reasons.<a class="elsevierStyleCrossRef" href="#bib0205">41</a> However, evolution of beliefs about illness origin has been observed in recent years (1996-2006), the change being directed towards a more biomedical framework. These changes could be justified according to television campaigns with reference to depression; they could also be due to client-directed marketing by pharmaceutical companies in the United States.<a class="elsevierStyleCrossRef" href="#bib0210">42</a>Up to 2/3 of those surveyed in Spain considered depression to be an illness, while the rest considered it a state of mind. Of the same sample, 80% considered it a psychological or mental illness. Furthermore, the respondents unanimously considered depression to be chronic. The causes most frequently indicated were labour, family and economic problems, stress, loss of a loved one and loneliness, confusing triggers with causes.<a class="elsevierStyleCrossRef" href="#bib0215">43</a>Beliefs about depression are factors associated with requesting professional help. The stigma associated with depression is frequent<a class="elsevierStyleCrossRef" href="#bib0220">44</a>; the beliefs that it is a stigmatizing condition and that one should be able to control one's own depressive state are associated with concealing symptoms from the doctor.<a class="elsevierStyleCrossRef" href="#bib0225">45</a> The most vulnerable groups would be those of extreme age categories (young people and the elderly), given the lower perception of illness and the attribution of difficulties to “normalised” life phases of the individual. This belief extends even to primary health care doctors, among whom difficulties have been identified for establishing treatment for these groups.<a class="elsevierStyleCrossRef" href="#bib0230">46</a>Beliefs about the causes of depression influence patients’ treatment preferences, as well as their assignment to 1 type of treatment or another. The preference for psychotherapy is associated with attribution of the aetiology to problems in childhood and to more complex aetiologies, compared to patients who prefer drug treatment.<a class="elsevierStyleCrossRef" href="#bib0235">47</a> Attribution to intra-individual causes is associated with assignment to cognitive behaviour therapy, while attribution to biological causes is associated with psychopharmacological treatment.<a class="elsevierStyleCrossRef" href="#bib0240">48</a> Beliefs in biomedical causes of depression are associated strongly with preference for antidepressant treatment.<a class="elsevierStyleCrossRef" href="#bib0245">49</a> For its part, a belief in non-medical models would interfere with standard biomedical treatment, which would be rejected as of little use or even harmful.<a class="elsevierStyleCrossRef" href="#bib0250">50</a>Beliefs about antidepressantsThe main negative beliefs about antidepressants are addictive possibilities (especially in males), over-medication and prescription abuse of antidepressants.<a class="elsevierStyleCrossRef" href="#bib0255">51</a>More than 2/3 of the population surveyed in Spain demonstrated beliefs regarding dependency caused by antidepressants, with this being the main adverse effect alleged as the reason for discontinuing the drugs after a short time.<a class="elsevierStyleCrossRef" href="#bib0215">43</a> Similar findings were obtained in older, 60-year-old depressed patients, with negative attitudes towards the treatment. The 2 main reasons for resistance to taking antidepressants were fear of dependence and resistance to seeing depressive symptoms as a medical illness.<a class="elsevierStyleCrossRef" href="#bib0260">52</a> Adolescents preferred psychotherapy over drugs, and the main adverse effects that would make adherence to antidepressant treatment difficult for them were the increase of weight for girls and the sexual effects for boys.<a class="elsevierStyleCrossRef" href="#bib0265">53</a> Patients with major depressive disorder appeared to have a more negative view of antidepressants than those with bipolar disorder.<a class="elsevierStyleCrossRef" href="#bib0270">54</a>Based on Horne's model, it has been found that the need for antidepressant treatment is associated with older age, greater severity of depressive symptoms, expecting a longer duration of symptoms and attributing the illness to a chemical imbalance. The belief that the treatment is harmful is associated with failing to take antidepressants early, attributing symptoms to random factors and poor understanding of depressive symptoms.<a class="elsevierStyleCrossRef" href="#bib0275">55</a>It is difficult to differentiate the stigmatizing beliefs related to depression from those related to antidepressants. Resisting or rejecting the use of antidepressants could be a way of avoiding the label of mentally ill.<a class="elsevierStyleCrossRef" href="#bib0280">56</a> In some cases, depression is seen as a sign of weakness, and antidepressants as indicators of the “mentally weak” or “those unable to cope with their emotional problems”.<a class="elsevierStyleCrossRefs" href="#bib0215">43,57</a>Beliefs about psychotherapy vs medicationPreferring psychotherapy to drugs is consistently established in studies of patients with depression, primary care patients and the general population.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> It has been found in the Spanish general population, even in relation to schizophrenia and bipolar disorder.<a class="elsevierStyleCrossRef" href="#bib0290">58</a> The factors associated with this preference include female sex, greater knowledge of psychotherapy or previous experience with it, paid time off and not having been recently treated with antidepressants.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> Patients in serious condition also perceive the usefulness of pharmacological and psychotherapeutic co-therapy,<a class="elsevierStyleCrossRef" href="#bib0015">3</a> from which they can learn coping mechanisms and change their thinking patterns, patterns of coping with stress and difficult relationships.<a class="elsevierStyleCrossRefs" href="#bib0295">59,60</a> This preference is maintained today, including in developed countries. However, there has been a gradual rise in positive assessments of psychotropic drugs, coinciding with increased rates of request for assistance from depressed patients.<a class="elsevierStyleCrossRef" href="#bib0305">61</a> Consequently, people familiar with treatment of depression tended to be more willing to recommend seeking help from mental health professionals, and to adopt various treatment options, especially medication.<a class="elsevierStyleCrossRef" href="#bib0310">62</a> This positive correlation in the perceived usefulness of treatment and the possibility of help from mental health professionals appeared more frequently in women,<a class="elsevierStyleCrossRef" href="#bib0315">63</a> in patients without a partner (separated, divorced or widowed), those who have received prior psychiatric treatment<a class="elsevierStyleCrossRef" href="#bib0300">60</a> and in patients with a more serious condition. For the general population or patients with a milder illness, higher importance is attributed to the family figure as support and to social workers or counsellors compared to mental health professionals.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> The perceived efficiency of these types of treatments is also favourable to psychotherapy in the general population and in primary care patients, especially in the case of males and the elderly population. In the case of depressed patients, studies have been heterogeneous, some favouring psychotherapy and others medication.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> Symptoms of cluster B personality disorders have been associated with a negative attitude towards psychotherapy and poor adherence to this treatment in patients with major depression, while symptoms from cluster C personality disorders were associated with a positive attitude.<a class="elsevierStyleCrossRef" href="#bib0055">11</a>AssessmentGiven the importance of the beliefs and attitudes for adherence, these aspects need to be assessed in all patients. Although the most habitual method will be evaluation in the context of the clinical interview, there are psychometric scales available, some of which are validated in Spain.Various factors can affect the validity of the attitudes reported by the patient about the medication, such as certain symptoms, stigma and social desirability. Consequently, using simplified interviews, performing the assessment when the patient is stable or has minimal symptoms and avoiding administering stigmatizing assessments (e.g., a symptom rating scale) have been recommended when assessing adherence.<a class="elsevierStyleCrossRef" href="#bib0320">64</a>The Beliefs about Medicines Questionnaire (BMQ)<a class="elsevierStyleCrossRef" href="#bib0325">65</a> was designed to evaluate beliefs about medication. It consists of 2 scales: 1 that assesses beliefs about medication in general (BMQ-General) and another scale that evaluates the patient's opinions on their specific treatment (BMQ-Specific). There is a validated version in Spain. Its study of psychometric properties—conducted with chronic, hypertensive, diabetic and university student patients—showed good validity and reliability; however, it would be advisable to carry out studies in other populations and with other types of treatment.<a class="elsevierStyleCrossRef" href="#bib0330">66</a>The Drug Attitude Inventory (DAI),<a class="elsevierStyleCrossRef" href="#bib0335">67</a> a widely used scale, was developed for patients with schizophrenia, although it has been used in different psychiatric disorders.<a class="elsevierStyleCrossRef" href="#bib0335">67</a> It assesses attitudes, beliefs and feelings in relation to taking medication, as well as the subjective effect of antipsychotics and illness awareness. The most commonly used version is one which is reduced to 10 items.<a class="elsevierStyleCrossRef" href="#bib0320">64</a> There is a validated version in Spanish.<a class="elsevierStyleCrossRef" href="#bib0340">68</a>There are other scales, although lacking validation in Spain, such as the Brief Evaluation of Medication Influences and Beliefs (BEMIB)<a class="elsevierStyleCrossRef" href="#bib0345">69</a> and the Rating of Medication Influences (ROMI),<a class="elsevierStyleCrossRef" href="#bib0350">70</a> both based on the Health Belief Model. The Medication Adherence Rating Scale (MARS),<a class="elsevierStyleCrossRef" href="#bib0355">71</a> initially developed for use in patients with schizophrenia and psychosis, assesses adherence and attitudes toward medication.Study limitations and methodological difficultiesIn studying beliefs towards depression and its treatment, questionnaires created by the authors are frequently used, although they are not validated and difficult to repeat. Only some have used validated belief scales such as the Beliefs about Medicines Questionnaire or the Drug Attitude Inventory.<a class="elsevierStyleCrossRefs" href="#bib0060">12,27,55</a> Most studies on adherence have used self-reported measures of adherence, with which its estimation is probably being over evaluated, given that patient-reported adherence is the least valid<a class="elsevierStyleCrossRef" href="#bib0320">64</a> and tends to be greater than the real figure.<a class="elsevierStyleCrossRef" href="#bib0360">72</a> On the other hand, in the articles reviewed, it is difficult to differentiate those beliefs that refer only to antidepressants from those that refer to psychotropic medications in general.<a class="elsevierStyleCrossRef" href="#bib0170">34</a> In the same vein, it is difficult to separate the perceived stigma related to depression from that related to antidepressant treatment. With samples of depressed patients, the study of beliefs about depression, its treatment and the variables related to it has the disadvantage that these beliefs may be influenced by the depression itself. The existence of depression, depressive symptoms<a class="elsevierStyleCrossRef" href="#bib0015">3</a> and the greater severity of these symptoms<a class="elsevierStyleCrossRef" href="#bib0275">55</a> have been found to influence beliefs about depression and antidepressant treatment, so it is important to have studies that evaluate these beliefs in the absence of depression.ConclusionsNon-adherence is a frequent phenomenon, both in antidepressant treatment and psychotherapy, reaching 30–60% overall. It is a multifactorial phenomenon and assessing risk factors is essential to address them later. Non-adherence to psychotherapy is still understudied. Beliefs and attitudes towards medication and psychotherapy potentially influence adherence and should be evaluated in all patients. There are multiple causal factors underlying these beliefs and attitudes and they are still understudied. Each patient should be assessed individually, since each person is unique in their personal history and their way of viewing depression and its treatment. Negative beliefs (misconceptions, prejudices), negative attitudes and possible stigma perceived towards medication and/or depression must be identified and addressed in the context of an appropriate therapeutic relationship. This is because these factors can be important in non-adherence and identifying them and the patient's preferences may point towards the type of treatment. Overall, there is currently a preference for psychotherapy. However, the positive assessment of psychopharmaceuticals has increased in the last few years, in line with movement towards a biomedical framework regarding beliefs about the aetiology of depression. On the other hand, given that beliefs and attitudes are changeable, influenced by various factors, they should be assessed throughout the evolution of the illness.Patient beliefs about depression and its treatment are an essential factor for adherence to both psychotherapy and psychotropic drugs and, therefore, for the development of the disorder. The search for the best possible adherence should take place in the context of a good therapeutic relationship, psychoeducation, assessing beliefs and attitudes towards medication and psychotherapy, dealing with any negative beliefs and attitudes and considering patient preferences.Conflict of interestsThe authors have no conflict of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:2 [ "identificador" => "xres114445" "titulo" => "Abstract" ] 1 => array:2 [ "identificador" => "xpalclavsec101759" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres114444" "titulo" => "Resumen" ] 3 => array:2 [ "identificador" => "xpalclavsec101760" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Adherence to antidepressant treatment" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Adherence to psychotherapy" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "How beliefs and attitudes towards treatment influence adherence" ] 8 => array:3 [ "identificador" => "sec0025" "titulo" => "Beliefs and attitudes towards depression, medication and psychotherapy" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0030" "titulo" => "Beliefs about depression" ] 1 => array:2 [ "identificador" => "sec0035" "titulo" => "Beliefs about antidepressants" ] 2 => array:2 [ "identificador" => "sec0040" "titulo" => "Beliefs about psychotherapy vs medication" ] 3 => array:2 [ "identificador" => "sec0045" "titulo" => "Assessment" ] ] ] 9 => array:2 [ "identificador" => "sec0050" "titulo" => "Study limitations and methodological difficulties" ] 10 => array:2 [ "identificador" => "sec0055" "titulo" => "Conclusions" ] 11 => array:2 [ "identificador" => "sec0060" "titulo" => "Conflict of interests" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2012-06-26" "fechaAceptado" => "2012-08-29" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec101759" "palabras" => array:6 [ 0 => "Beliefs about illness" 1 => "Antidepressants" 2 => "Psychotherapy" 3 => "Treatment" 4 => "Depression" 5 => "Treatment adherence" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec101760" "palabras" => array:6 [ 0 => "Creencias" 1 => "Antidepresivos" 2 => "Psicoterapia" 3 => "Tratamiento" 4 => "Depresión" 5 => "Adherencia" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "Beliefs and attitudes about treatment in patients with depression are significant factors related to treatment adherence. Despite their importance, few studies have evaluated the determining factors of these beliefs, and the positive or negative attitudes towards treatment. This review looks at areas such as, adherence to antidepressants and psychotherapy, influence of beliefs and attitudes on adherence to treatment, beliefs and attitudes about depression and its treatment, their assessment, variables associated with these beliefs, and limitations of available studies. Acknowledging the importance of patient beliefs about depression and treatment, and their assessment are essential to optimize the chances of success of therapy by identifying and addressing misconceptions, prejudices and negative attitudes, as well as the consideration of these aspects in order to improve treatment choice." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "Las creencias y actitudes frente al tratamiento en los pacientes con depresión son factores de incuestionable importancia para la adherencia al tratamiento. A pesar de su importancia, aún existen pocos estudios que hayan evaluado los factores determinantes de las creencias y actitudes negativas o positivas frente al tratamiento. En esta revisión se abordan las áreas de la adherencia al tratamiento antidepresivo y a la psicoterapia, la influencia de las creencias y actitudes frente al tratamiento sobre la adherencia, las creencias y actitudes frente a la depresión y sus tratamientos, su evaluación, las variables relacionadas con estas creencias, y las limitaciones de los estudios disponibles. La consideración y evaluación de las creencias de los pacientes respecto a la depresión y los tratamientos es esencial para optimizar las posibilidades de éxito de la terapia mediante la identificación y abordaje de concepciones erróneas, prejuicios y actitudes negativas, así como la consideración de estos aspectos en la elección del tratamiento." ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Acosta F, et al. Creencias sobre la depresión y sus tratamientos: variables asociadas e influencia de las creencias en la adherencia. Rev Psiquiatr Salud Ment (Barc.). 2013;6:86–92." ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:72 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effects of adherence to antidepressant treatment guidelines on relapse and recurrence of depression" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C.A. Melfi" 1 => "A.J. Chawla" 2 => "T.W. Croghan" 3 => "M.P. Hanna" 4 => "S. Kennedy" 5 => "K. Sredl" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Gen Psychiatry" "fecha" => "1998" "volumen" => "55" "paginaInicial" => "1128" "paginaFinal" => "1132" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9862557" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relationship of pharmacologic compliance to long-term prophylaxis in recurrent depression" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E. Frank" 1 => "J.M. Perel" 2 => "A.G. Mallinger" 3 => "M.E. Thase" 4 => "D.J. Kupfer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Psychopharmacol Bull" "fecha" => "1992" "volumen" => "28" "paginaInicial" => "231" "paginaFinal" => "235" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1480724" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Health beliefs and perceived need for mental health care of anxiety and depression—the patients’ perspective explored" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.A. Prins" 1 => "P.F.M. Verhaak" 2 => "J.M. Bensing" 3 => "K. van der Meer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.cpr.2008.02.009" "Revista" => array:6 [ "tituloSerie" => "Clin Psychol Rev" "fecha" => "2008" "volumen" => "28" "paginaInicial" => "1038" "paginaFinal" => "1058" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18420323" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Compliance with antidepressant therapy and antidepressant discontinuation symptoms" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K. Demyttenaere" 1 => "P. Haddad" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Psychiatr Scand Suppl" "fecha" => "2000" "volumen" => "403" "paginaInicial" => "50" "paginaFinal" => "56" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11019935" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The compliance with antidepressants in general practice" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.C. Maddox" 1 => "M. Levi" 2 => "C. Thompson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/026988119400800108" "Revista" => array:6 [ "tituloSerie" => "J Psychopharmacol" "fecha" => "1994" "volumen" => "8" "paginaInicial" => "48" "paginaFinal" => "52" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22298480" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Persistence and compliance to antidepressant treatment in patients with depression: a chart review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Sawada" 1 => "H. Uchida" 2 => "T. Suzuki" 3 => "K. Watanabe" 4 => "T. Kikuchi" 5 => "T. Handa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1471-244X-9-38" "Revista" => array:5 [ "tituloSerie" => "BMC Psychiatry" "fecha" => "2009" "volumen" => "9" "paginaInicial" => "38" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19531229" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment non-adherence in affective disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Lingam" 1 => "J. Scott" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Psychiatr Scand" "fecha" => "2002" "volumen" => "105" "paginaInicial" => "164" "paginaFinal" => "172" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11939969" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "La adherencia en los trastornos afectivos" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R. Touriño González" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Cuadernos de Psiquiatría Comunitaria" "fecha" => "2009" "volumen" => "9" "paginaInicial" => "49" "paginaFinal" => "66" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Collaborative management to achieve depression treatment guidelines" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W. Katon" 1 => "M. Von Korff" 2 => "E. Lin" 3 => "G. Simon" 4 => "E. Walker" 5 => "T. Bush" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Clin Psychiatry" "fecha" => "1997" "volumen" => "58" "numero" => "Suppl. 1" "paginaInicial" => "S20" "paginaFinal" => "S23" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "National Collaborating Centre for Mental Health (UK). Depression: the treatment and management of depression in adults (Updated edition). Leicester (UK): British Psychological Society; 2010 (NICE Clinical Guidelines, N.°. 90). Available from: <a class="elsevierStyleInterRef" href="http://www.ncbi.nlm.nih.gov/books/NBK63748/">http://www.ncbi.nlm.nih.gov/books/NBK63748/</a> [accessed 17 August 2012]." ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment attitudes and adherence of psychiatric patients with major depressive disorder: a five-year prospective study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "I.A.K. Holma" 1 => "K.M. Holma" 2 => "T.K. Melartin" 3 => "E.T. Isometsä" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jad.2010.04.022" "Revista" => array:6 [ "tituloSerie" => "J Affect Disord" "fecha" => "2010" "volumen" => "127" "paginaInicial" => "102" "paginaFinal" => "112" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20546916" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adherence to maintenance-phase antidepressant medication as a function of patient beliefs about medication" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.E. Aikens" 1 => "D.E. Nease" 2 => "D.P. Nau" 3 => "M.S. Klinkman" 4 => "T.L. Schwenk" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1370/afm.238" "Revista" => array:6 [ "tituloSerie" => "Ann Fam Med" "fecha" => "2005" "volumen" => "3" "paginaInicial" => "23" "paginaFinal" => "30" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15671187" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Patients’ perceptions and illness severity at start of antidepressant treatment in general practice" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E.C.G. Van Geffen" 1 => "E.R. Heerdink" 2 => "J.G. Hugtenburg" 3 => "F.W. Siero" 4 => "A.C.G. Egberts" 5 => "R. Van Hulten" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.2042-7174.2010.00035.x" "Revista" => array:6 [ "tituloSerie" => "Int J Pharm Pract" "fecha" => "2010" "volumen" => "18" "paginaInicial" => "217" "paginaFinal" => "225" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20636673" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A meta-analysis of psychotherapy dropout" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Wierzbicki" 1 => "G. Pekarik" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Prof Psychol Res Pr" "fecha" => "1993" "volumen" => "24" "paginaInicial" => "190" "paginaFinal" => "195" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Psychotherapy dropout: a meta-analytic review of premature termination" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J. Sharf" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Diss Abstr Int: B: Sci Eng" "fecha" => "2008" "volumen" => "68" "paginaInicial" => "6336" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Better compliance: physicians making it happen" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.M. Bachman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am Fam Phys" "fecha" => "1993" "volumen" => "48" "paginaInicial" => "717" "paginaFinal" => "718" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Factors involved in failure to keep initial appointments with mental health professionals" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "I.R. Nicholson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Hosp Community Psychiatry" "fecha" => "1994" "volumen" => "45" "paginaInicial" => "276" "paginaFinal" => "278" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8188204" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Therapy termination and persistence patterns of elderly clients in a community mental health center" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P.M. Mosher-Ashley" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "The Gerontologist" "fecha" => "1994" "volumen" => "34" "paginaInicial" => "180" "paginaFinal" => "189" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8005490" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Brief psychodynamic individual psychotherapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H. Levenson" 1 => "S. Butler" 2 => "E. Bein" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:2 [ "titulo" => "Textbook of psychiatry" "serieFecha" => "2002" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neurotic patients who terminate their own treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H. Roberts" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Psychiatry" "fecha" => "1985" "volumen" => "146" "paginaInicial" => "442" "paginaFinal" => "445" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4016449" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors of compliance with psychological interventions offered in the community" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.L. Ayuso-Mateos" 1 => "A. Pereda" 2 => "G. Dunn" 3 => "J.L. Vázquez-Barquero" 4 => "P. Casey" 5 => "V. Lehtinen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1017/S0033291706009317" "Revista" => array:6 [ "tituloSerie" => "Psychol Med" "fecha" => "2007" "volumen" => "37" "paginaInicial" => "717" "paginaFinal" => "725" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17094818" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effectiveness of psychotherapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.J. Lambert" 1 => "D.A. Shapiro" 2 => "A.E. Bergin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Handbook of psychotherapy and behavior change" "paginaInicial" => "157" "paginaFinal" => "212" "serieFecha" => "1986" ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relation between working alliance and outcome in psychotherapy: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.O. Horvath" 1 => "B.D. Symonds" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Couns Psychol" "fecha" => "1991" "volumen" => "38" "paginaInicial" => "139" "paginaFinal" => "149" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "La alianza terapéutica: historia, investigación y evaluación" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Corbella" 1 => "L. Botella" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Anales de psicología (Murcia, Spain)" "fecha" => "2003" "volumen" => "19" "paginaInicial" => "205" "paginaFinal" => "221" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Health beliefs, disease severity, and patient adherence: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.R. DiMatteo" 1 => "K.B. Haskard" 2 => "S.L. Williams" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MLR.0b013e318032937e" "Revista" => array:6 [ "tituloSerie" => "Med Care" "fecha" => "2007" "volumen" => "45" "paginaInicial" => "521" "paginaFinal" => "528" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17515779" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0130" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Personal stigma and use of mental health services among people with depression in a general population in Finland" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Aromaa" 1 => "A. Tolvanen" 2 => "J. Tuulari" 3 => "K. Wahlbeck" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1471-244X-11-52" "Revista" => array:5 [ "tituloSerie" => "BMC Psychiatry" "fecha" => "2011" "volumen" => "11" "paginaInicial" => "52" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21453504" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0135" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nontricyclic antidepressants: predictors of nonadherence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "O.H. Brook" 1 => "H.P.J. Van Hout" 2 => "W.A.B. Stalman" 3 => "M. De Haan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.jcp.0000246217.34024.53" "Revista" => array:6 [ "tituloSerie" => "J Clin Psychopharmacol" "fecha" => "2006" "volumen" => "26" "paginaInicial" => "643" "paginaFinal" => "647" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17110823" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0140" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Beliefs about medications predict adherence to antidepressants in older adults" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "W. Fawzi" 1 => "M.Y. Abdel Mohsen" 2 => "A.H. Hashem" 3 => "S. Moussa" 4 => "E. Coker" 5 => "K.C.M. Wilson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1017/S1041610211001049" "Revista" => array:6 [ "tituloSerie" => "Int Psychogeriatr" "fecha" => "2012" "volumen" => "24" "paginaInicial" => "159" "paginaFinal" => "169" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21729414" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0145" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Medication beliefs and adherence to antidepressants in primary care" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Russell" 1 => "N. Kazantzis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "N Z Med J" "fecha" => "2008" "volumen" => "121" "paginaInicial" => "14" "paginaFinal" => "20" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19098944" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0150" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mediating roles of adherence attitude and patient education on antidepressant use in patients with depression" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G.-C. Sun" 1 => "M.-C. Hsu" 2 => "W. Moyle" 3 => "M.-F. Lin" 4 => "D. Creedy" 5 => "L. Venturato" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1744-6163.2010.00257.x" "Revista" => array:6 [ "tituloSerie" => "Perspect Psychiatr Care" "fecha" => "2011" "volumen" => "47" "paginaInicial" => "13" "paginaFinal" => "22" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21418069" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0155" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of antidepressant drug counselling and information leaflets on adherence to drug treatment in primary care: randomised controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Peveler" 1 => "C. George" 2 => "A.L. Kinmonth" 3 => "M. Campbell" 4 => "C. Thompson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "BMJ" "fecha" => "1999" "volumen" => "319" "paginaInicial" => "612" "paginaFinal" => "615" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10473477" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0160" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Improving patients’ beliefs about antidepressants in primary care: a cluster-randomized controlled trial of the effect of a depression care program" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.C. Vergouwen" 1 => "H. Burger" 2 => "T.J. Verheij" 3 => "F. Koerselman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Prim Care Companion J Clin Psychiatry" "fecha" => "2009" "volumen" => "11" "paginaInicial" => "48" "paginaFinal" => "52" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19617933" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0165" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The development and psychometric assessment of an instrument to measure attitudes towards depression and its treatments in patients suffering from non-psychotic depression" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Gabriel" 1 => "C. Violato" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jad.2009.11.009" "Revista" => array:6 [ "tituloSerie" => "J Affect Disord" "fecha" => "2010" "volumen" => "124" "paginaInicial" => "241" "paginaFinal" => "249" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19944465" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0170" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Perceptions of and attitudes toward antidepressants: stigma attached to their use—a review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.M. Castaldelli-Maia" 1 => "L.B. Scomparini" 2 => "A.G. De Andrade" 3 => "D. Bhugra" 4 => "T.C. De Toledo Ferraz Álves" 5 => "G. D’Elia" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/NMD.0b013e3182388950" "Revista" => array:6 [ "tituloSerie" => "J Nerv Ment Dis" "fecha" => "2011" "volumen" => "199" "paginaInicial" => "866" "paginaFinal" => "871" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22048139" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0175" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Exploring the nature of stigmatising beliefs about depression and help-seeking: implications for reducing stigma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L.J. Barney" 1 => "K.M. Griffiths" 2 => "H. Christensen" 3 => "A.F. Jorm" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1471-2458-9-61" "Revista" => array:5 [ "tituloSerie" => "BMC Public Health" "fecha" => "2009" "volumen" => "9" "paginaInicial" => "61" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19228435" "web" => "Medline" ] ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0180" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment perception and self-regulation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.E. Horne" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "The self-regulation of health and illness behaviour" "paginaInicial" => "138" "paginaFinal" => "153" "serieFecha" => "2003" ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0185" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of the primary care physician in patients’ adherence to antidepressant therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E.H. Lin" 1 => "M. Von Korff" 2 => "W. Katon" 3 => "T. Bush" 4 => "G.E. Simon" 5 => "E. Walker" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med Care" "fecha" => "1995" "volumen" => "33" "paginaInicial" => "67" "paginaFinal" => "74" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7823648" "web" => "Medline" ] ] ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib0190" "etiqueta" => "38" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Changes in patients’ beliefs about their antidepressant during the acute phase of depression treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.E. Aikens" 1 => "M.S. Klinkman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.genhosppsych.2012.01.004" "Revista" => array:6 [ "tituloSerie" => "Gen Hosp Psychiatry" "fecha" => "2012" "volumen" => "34" "paginaInicial" => "221" "paginaFinal" => "226" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22325627" "web" => "Medline" ] ] ] ] ] ] ] ] 38 => array:3 [ "identificador" => "bib0195" "etiqueta" => "39" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The health belief model: a decade later" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "N.K. Janz" 1 => "M.H. Becker" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Health Educ Q" "fecha" => "1984" "volumen" => "11" "paginaInicial" => "1" "paginaFinal" => "47" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6392204" "web" => "Medline" ] ] ] ] ] ] ] ] 39 => array:3 [ "identificador" => "bib0200" "etiqueta" => "40" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Beliefs about depression and depression treatment among depressed veterans" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.J. Edlund" 1 => "J.C. Fortney" 2 => "C.M. Reaves" 3 => "J.M. Pyne" 4 => "D. Mittal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MLR.0b013e3181648e46" "Revista" => array:6 [ "tituloSerie" => "Med Care" "fecha" => "2008" "volumen" => "46" "paginaInicial" => "581" "paginaFinal" => "589" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18520312" "web" => "Medline" ] ] ] ] ] ] ] ] 40 => array:3 [ "identificador" => "bib0205" "etiqueta" => "41" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Patients’ beliefs about the cause of their depression" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Hansson" 1 => "J. Chotai" 2 => "O. Bodlund" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jad.2009.10.032" "Revista" => array:6 [ "tituloSerie" => "J Affect Disord" "fecha" => "2010" "volumen" => "124" "paginaInicial" => "54" "paginaFinal" => "59" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19923007" "web" => "Medline" ] ] ] ] ] ] ] ] 41 => array:3 [ "identificador" => "bib0210" "etiqueta" => "42" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Changing perceptions of depression: ten-year trends from the general social survey" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K.H. Blumner" 1 => "S.C. Marcus" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1176/appi.ps.60.3.306" "Revista" => array:6 [ "tituloSerie" => "Psychiatr Serv" "fecha" => "2009" "volumen" => "60" "paginaInicial" => "306" "paginaFinal" => "312" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19252042" "web" => "Medline" ] ] ] ] ] ] ] ] 42 => array:3 [ "identificador" => "bib0215" "etiqueta" => "43" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Knowledge and perception about depression in the Spanish population" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Comas" 1 => "E. Álvarez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Esp Psiquiatr" "fecha" => "2004" "volumen" => "32" "paginaInicial" => "371" "paginaFinal" => "376" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15529227" "web" => "Medline" ] ] ] ] ] ] ] ] 43 => array:3 [ "identificador" => "bib0220" "etiqueta" => "44" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Stigma and depression among primary care patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. Roeloffs" 1 => "C. Sherbourne" 2 => "J. Unützer" 3 => "A. Fink" 4 => "L. Tang" 5 => "K.B. Wells" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Gen Hosp Psychiatry" "fecha" => "2003" "volumen" => "25" "paginaInicial" => "311" "paginaFinal" => "315" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12972221" "web" => "Medline" ] ] ] ] ] ] ] ] 44 => array:3 [ "identificador" => "bib0225" "etiqueta" => "45" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Suffering in silence: reasons for not disclosing depression in primary care" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.A. Bell" 1 => "P. Franks" 2 => "P.R. Duberstein" 3 => "R.M. Epstein" 4 => "M.D. Feldman" 5 => "E. García" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1370/afm.1277" "Revista" => array:6 [ "tituloSerie" => "Ann Fam Med" "fecha" => "2011" "volumen" => "9" "paginaInicial" => "439" "paginaFinal" => "446" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21911763" "web" => "Medline" ] ] ] ] ] ] ] ] 45 => array:3 [ "identificador" => "bib0230" "etiqueta" => "46" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Justifiable depression: how primary care professionals and patients view late-life depression? A qualitative study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "H. Burroughs" 1 => "K. Lovell" 2 => "M. Morley" 3 => "R. Baldwin" 4 => "A. Burns" 5 => "C. Chew-Graham" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/fampra/cmi115" "Revista" => array:6 [ "tituloSerie" => "Fam Pract" "fecha" => "2006" "volumen" => "23" "paginaInicial" => "369" "paginaFinal" => "377" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16476699" "web" => "Medline" ] ] ] ] ] ] ] ] 46 => array:3 [ "identificador" => "bib0235" "etiqueta" => "47" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Beliefs about the causes of depression and treatment preferences" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.R. Khalsa" 1 => "K.S. McCarthy" 2 => "B.A. Sharpless" 3 => "M.S. Barrett" 4 => "J.P. Barber" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jclp.20785" "Revista" => array:6 [ "tituloSerie" => "J Clin Psychol" "fecha" => "2011" "volumen" => "67" "paginaInicial" => "539" "paginaFinal" => "549" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21365652" "web" => "Medline" ] ] ] ] ] ] ] ] 47 => array:3 [ "identificador" => "bib0240" "etiqueta" => "48" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Does illness attribution affect treatment assignment in depression?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Schweizer" 1 => "F. Peeters" 2 => "M. Huibers" 3 => "J. Roelofs" 4 => "J. Van Os" 5 => "A. Arntz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/cpp.662" "Revista" => array:6 [ "tituloSerie" => "Clin Psychol Psychother" "fecha" => "2010" "volumen" => "17" "paginaInicial" => "418" "paginaFinal" => "426" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19911389" "web" => "Medline" ] ] ] ] ] ] ] ] 48 => array:3 [ "identificador" => "bib0245" "etiqueta" => "49" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Depression treatment preferences of Hispanic individuals: exploring the influence of ethnicity, language, and explanatory models" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Y. Fernández" 1 => "E. García" 2 => "P. Franks" 3 => "A. Jerant" 4 => "R.A. Bell" 5 => "R.L. Kravitz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3122/jabfm.2011.01.100118" "Revista" => array:6 [ "tituloSerie" => "J Am Board Fam Med" "fecha" => "2011" "volumen" => "24" "paginaInicial" => "39" "paginaFinal" => "50" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21209343" "web" => "Medline" ] ] ] ] ] ] ] ] 49 => array:3 [ "identificador" => "bib0250" "etiqueta" => "50" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Patient attitudes regarding causes of depression: implications for psychoeducation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Srinivasan" 1 => "N.L. Cohen" 2 => "S.V. Parikh" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Can J Psychiatry" "fecha" => "2003" "volumen" => "48" "paginaInicial" => "493" "paginaFinal" => "495" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12971021" "web" => "Medline" ] ] ] ] ] ] ] ] 50 => array:3 [ "identificador" => "bib0255" "etiqueta" => "51" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Beliefs about antidepressant medications in primary care patients: relationship to self-reported adherence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. Brown" 1 => "D.R. Battista" 2 => "R. Bruehlman" 3 => "S.S. Sereika" 4 => "M.E. Thase" 5 => "J. Dunbar-Jacob" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med Care" "fecha" => "2005" "volumen" => "43" "paginaInicial" => "1203" "paginaFinal" => "1207" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16299431" "web" => "Medline" ] ] ] ] ] ] ] ] 51 => array:3 [ "identificador" => "bib0260" "etiqueta" => "52" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Older patients’ aversion to antidepressants. A qualitative study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.L. Givens" 1 => "C.J. Datto" 2 => "K. Ruckdeschel" 3 => "K. Knott" 4 => "C. Zubritsky" 5 => "D.W. Oslin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1525-1497.2005.00296.x" "Revista" => array:6 [ "tituloSerie" => "J Gen Intern Med" "fecha" => "2006" "volumen" => "21" "paginaInicial" => "146" "paginaFinal" => "151" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16336620" "web" => "Medline" ] ] ] ] ] ] ] ] 52 => array:3 [ "identificador" => "bib0265" "etiqueta" => "53" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adolescents’ attitudes and opinions about depression treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K.L. Bradley" 1 => "P.J. McGrath" 2 => "C.L. Brannen" 3 => "A.L. Bagnell" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10597-009-9224-5" "Revista" => array:6 [ "tituloSerie" => "Community Ment Health J" "fecha" => "2010" "volumen" => "46" "paginaInicial" => "242" "paginaFinal" => "251" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19636707" "web" => "Medline" ] ] ] ] ] ] ] ] 53 => array:3 [ "identificador" => "bib0270" "etiqueta" => "54" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Depressive and bipolar disorders: patients’ attitudes and beliefs towards depression and antidepressants" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L.V. Kessing" 1 => "H.V. Hansen" 2 => "K. Demyttenaere" 3 => "P. Bech" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Psychol Med" "fecha" => "2005" "volumen" => "35" "paginaInicial" => "1205" "paginaFinal" => "1213" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16116946" "web" => "Medline" ] ] ] ] ] ] ] ] 54 => array:3 [ "identificador" => "bib0275" "etiqueta" => "55" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Explaining patients’ beliefs about the necessity and harmfulness of antidepressants" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.E. Aikens" 1 => "D.E. Nease" 2 => "M.S. Klinkman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1370/afm.759" "Revista" => array:6 [ "tituloSerie" => "Ann Fam Med" "fecha" => "2008" "volumen" => "6" "paginaInicial" => "23" "paginaFinal" => "29" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18195311" "web" => "Medline" ] ] ] ] ] ] ] ] 55 => array:3 [ "identificador" => "bib0280" "etiqueta" => "56" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "“Medication career” or “moral career”? The two sides of managing antidepressants: a meta-ethnography of patients’ experience of antidepressants" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Malpass" 1 => "A. Shaw" 2 => "D. Sharp" 3 => "F. Walter" 4 => "G. Feder" 5 => "M. Ridd" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.socscimed.2008.09.068" "Revista" => array:6 [ "tituloSerie" => "Soc Sci Med" "fecha" => "2009" "volumen" => "68" "paginaInicial" => "154" "paginaFinal" => "168" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19013702" "web" => "Medline" ] ] ] ] ] ] ] ] 56 => array:3 [ "identificador" => "bib0285" "etiqueta" => "57" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A qualitative analysis of the perception of stigma among Latinos receiving antidepressants" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Interian" 1 => "I.E. Martínez" 2 => "P.J. Guarnaccia" 3 => "W.A. Vega" 4 => "J.I. Escobar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1176/ps.2007.58.12.1591" "Revista" => array:6 [ "tituloSerie" => "Psychiatr Serv" "fecha" => "2007" "volumen" => "58" "paginaInicial" => "1591" "paginaFinal" => "1594" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18048562" "web" => "Medline" ] ] ] ] ] ] ] ] 57 => array:3 [ "identificador" => "bib0290" "etiqueta" => "58" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Opinions and beliefs of the Spanish population on serious mental illnesses (schizophrenia and bipolar disorder)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.Á. Ruiz" 1 => "J.M. Montes" 2 => "J. Correas Lauffer" 3 => "C. Álvarez" 4 => "J. Mauriño" 5 => "C. De Dios Perrino" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rpsm.2012.01.002" "Revista" => array:6 [ "tituloSerie" => "Rev Psiquiatr Salud Ment" "fecha" => "2012" "volumen" => "5" "paginaInicial" => "98" "paginaFinal" => "106" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22854580" "web" => "Medline" ] ] ] ] ] ] ] ] 58 => array:3 [ "identificador" => "bib0295" "etiqueta" => "59" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assessing patient beliefs in a clinical trial of Hypericum perforatum in major depression" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C.M. Bann" 1 => "C.B. Parker" 2 => "J. Bradwejn" 3 => "J.R.T. Davidson" 4 => "B. Vitiello" 5 => "K.M. Gadde" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/da.20036" "Revista" => array:6 [ "tituloSerie" => "Depress Anxiety" "fecha" => "2004" "volumen" => "20" "paginaInicial" => "114" "paginaFinal" => "122" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15549690" "web" => "Medline" ] ] ] ] ] ] ] ] 59 => array:3 [ "identificador" => "bib0300" "etiqueta" => "60" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The acceptability of treatment for depression among African-American Hispanic, and white primary care patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L.A. Cooper" 1 => "J.J. Gonzales" 2 => "J.J. Gallo" 3 => "K.M. Rost" 4 => "L.S. Meredith" 5 => "L.V. Rubenstein" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.MLR.0000053228.58042.E4" "Revista" => array:6 [ "tituloSerie" => "Med Care" "fecha" => "2003" "volumen" => "41" "paginaInicial" => "479" "paginaFinal" => "489" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12665712" "web" => "Medline" ] ] ] ] ] ] ] ] 60 => array:3 [ "identificador" => "bib0305" "etiqueta" => "61" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Public belief systems about the helpfulness of interventions for depression: associations with history of depression and professional help-seeking" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.F. Jorm" 1 => "H. Christensen" 2 => "J. Medway" 3 => "A.E. Korten" 4 => "P.A. Jacomb" 5 => "B. Rodgers" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Soc Psychiatry Psychiatr Epidemiol" "fecha" => "2000" "volumen" => "35" "paginaInicial" => "211" "paginaFinal" => "219" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10941996" "web" => "Medline" ] ] ] ] ] ] ] ] 61 => array:3 [ "identificador" => "bib0310" "etiqueta" => "62" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "What to do about depression? Help-seeking and treatment recommendations of the public" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Holzinger" 1 => "H. Matschinger" 2 => "M.C. Angermeyer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Epidemiol Psychiatr Sci" "fecha" => "2011" "volumen" => "20" "paginaInicial" => "163" "paginaFinal" => "169" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21714363" "web" => "Medline" ] ] ] ] ] ] ] ] 62 => array:3 [ "identificador" => "bib0315" "etiqueta" => "63" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Depression treatment preferences in younger and older adults" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P.D. Rokke" 1 => "F. Scogin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Clin Geropsychol" "fecha" => "1995" "volumen" => "1" "paginaInicial" => "243" "paginaFinal" => "257" ] ] ] ] ] ] 63 => array:3 [ "identificador" => "bib0320" "etiqueta" => "64" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Measurement of psychiatric treatment adherence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Sajatovic" 1 => "D.I. Velligan" 2 => "P.J. Weiden" 3 => "M.A. Valenstein" 4 => "G. Ogedegbe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jpsychores.2009.05.007" "Revista" => array:6 [ "tituloSerie" => "J Psychosom Res" "fecha" => "2010" "volumen" => "69" "paginaInicial" => "591" "paginaFinal" => "599" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21109048" "web" => "Medline" ] ] ] ] ] ] ] ] 64 => array:3 [ "identificador" => "bib0325" "etiqueta" => "65" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The beliefs about medicines questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Horne" 1 => "J. Weinman" 2 => "M. Hankins" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Psychol Health" "fecha" => "1999" "volumen" => "14" "paginaInicial" => "1" "paginaFinal" => "24" ] ] ] ] ] ] 65 => array:3 [ "identificador" => "bib0330" "etiqueta" => "66" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluación de las creencias sobre el tratamiento: validez fiabilidad de la versión española del Beliefs About Medicines Questionnaire" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Beléndez Vázquez" 1 => "A. Hernández Mijares" 2 => "R. Horne" 3 => "J. Weinman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Int J Clin Health Psychol" "fecha" => "2007" "volumen" => "7" "paginaInicial" => "767" "paginaFinal" => "779" ] ] ] ] ] ] 66 => array:3 [ "identificador" => "bib0335" "etiqueta" => "67" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T.P. Hogan" 1 => "A.G. Awad" 2 => "R. Eastwood" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Psychol Med" "fecha" => "1983" "volumen" => "13" "paginaInicial" => "177" "paginaFinal" => "183" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6133297" "web" => "Medline" ] ] ] ] ] ] ] ] 67 => array:3 [ "identificador" => "bib0340" "etiqueta" => "68" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assessment of drug attitudes in patients with schizophrenia: psychometric properties of the DAI Spanish version" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R. Robles García" 1 => "V. Salazar Alvarado" 2 => "F. Páez Agraz" 3 => "F. Ramírez Barreto" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Esp Psiquiatr" "fecha" => "2004" "volumen" => "32" "paginaInicial" => "138" "paginaFinal" => "142" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15168263" "web" => "Medline" ] ] ] ] ] ] ] ] 68 => array:3 [ "identificador" => "bib0345" "etiqueta" => "69" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Brief evaluation of medication influences and beliefs: development and testing of a brief scale for medication adherence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C.R. Dolder" 1 => "J.P. Lacro" 2 => "K.A. Warren" 3 => "S. Golshan" 4 => "D.O. Perkins" 5 => "D.V. Jeste" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Clin Psychopharmacol" "fecha" => "2004" "volumen" => "24" "paginaInicial" => "404" "paginaFinal" => "409" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15232332" "web" => "Medline" ] ] ] ] ] ] ] ] 69 => array:3 [ "identificador" => "bib0350" "etiqueta" => "70" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rating of medication influences (ROMI) scale in schizophrenia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Weiden" 1 => "B. Rapkin" 2 => "T. Mott" 3 => "A. Zygmunt" 4 => "D. Goldman" 5 => "M. Horvitz-Lennon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Schizophr Bull" "fecha" => "1994" "volumen" => "20" "paginaInicial" => "297" "paginaFinal" => "310" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7916162" "web" => "Medline" ] ] ] ] ] ] ] ] 70 => array:3 [ "identificador" => "bib0355" "etiqueta" => "71" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reliability and validity of a new Medication Adherence Rating Scale (MARS) for the psychoses" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K. Thompson" 1 => "J. Kulkarni" 2 => "A.A. Sergejew" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Schizophr Res" "fecha" => "2000" "volumen" => "42" "paginaInicial" => "241" "paginaFinal" => "247" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10785582" "web" => "Medline" ] ] ] ] ] ] ] ] 71 => array:3 [ "identificador" => "bib0360" "etiqueta" => "72" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of noncompliance in schizophrenia patients using electronic monitoring (MEMS) and its relationship to sociodemographic, clinical and psychopathological variables" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F.J. Acosta" 1 => "E. Bosch" 2 => "G. Sarmiento" 3 => "N. Juanes" 4 => "A. Caballero-Hidalgo" 5 => "T. Mayans" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.schres.2008.09.007" "Revista" => array:6 [ "tituloSerie" => "Schizophr Res" "fecha" => "2009" "volumen" => "107" "paginaInicial" => "213" "paginaFinal" => "217" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18849150" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735050/0000000600000002/v1_201305031504/S2173505012000957/v1_201305031504/en/main.assets" "Apartado" => array:4 [ "identificador" => "7615" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Review article" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735050/0000000600000002/v1_201305031504/S2173505012000957/v1_201305031504/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173505012000957?idApp=UINPBA00004N"]

Statistics

Review article

Beliefs about depression and its treatments: Associated variables and the influence of beliefs on adherence to treatment

Creencias sobre la depresión y sus tratamientos: variables asociadas e influencia de las creencias en la adherencia

Francisco Acostaa,

Corresponding author

fjacostaartiles@hotmail.com

Corresponding author.

, Luciano Rodríguezb, Beatriz Cabrerab

a Servicio de Salud Mental, Dirección General de Programas Asistenciales, Gran Canaria, Canarias, Spain

b Servicio de Psiquiatría, Hospital Universitario de Gran Canaria Dr. Negrín, Gran Canaria, Canarias, Spain

Read

8544

Times
was read the article

1648

Total PDF

6896

Total HTML

Share statistics

 array:24 [
  "pii" => "S2173505012000957"
  "issn" => "21735050"
  "doi" => "10.1016/j.rpsmen.2012.08.002"
  "estado" => "S300"
  "fechaPublicacion" => "2013-04-01"
  "aid" => "187"
  "copyright" => "SEP y SEPB"
  "copyrightAnyo" => "2012"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "ssu"
  "cita" => "Rev Psiquiatr Salud Ment. 2013;6:86-92"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 3154
    "formatos" => array:3 [
      "EPUB" => 21
      "HTML" => 2360
      "PDF" => 773
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S1888989112001693"
      "issn" => "18889891"
      "doi" => "10.1016/j.rpsm.2012.08.001"
      "estado" => "S300"
      "fechaPublicacion" => "2013-04-01"
      "aid" => "187"
      "copyright" => "SEP y SEPB"
      "documento" => "article"
      "crossmark" => 0
      "subdocumento" => "ssu"
      "cita" => "Rev Psiquiatr Salud Ment. 2013;6:86-92"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 7058
        "formatos" => array:3 [
          "EPUB" => 9
          "HTML" => 5298
          "PDF" => 1751
        ]
      ]
      "es" => array:12 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Revisi&#243;n</span>"
        "titulo" => "Creencias sobre la depresi&#243;n y sus tratamientos&#58; variables asociadas e influencia de las creencias en la adherencia"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "86"
            "paginaFinal" => "92"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Beliefs about depression and its treatments&#58; Associated variables and the influence of beliefs on adherence to treatment"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Francisco Acosta, Luciano Rodr&#237;guez, Beatriz Cabrera"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "Francisco"
                "apellidos" => "Acosta"
              ]
              1 => array:2 [
                "nombre" => "Luciano"
                "apellidos" => "Rodr&#237;guez"
              ]
              2 => array:2 [
                "nombre" => "Beatriz"
                "apellidos" => "Cabrera"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173505012000957"
          "doi" => "10.1016/j.rpsmen.2012.08.002"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173505012000957?idApp=UINPBA00004N"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888989112001693?idApp=UINPBA00004N"
      "url" => "/18889891/0000000600000002/v1_201305031459/S1888989112001693/v1_201305031459/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2173505012000970"
    "issn" => "21735050"
    "doi" => "10.1016/j.rpsmen.2012.09.002"
    "estado" => "S300"
    "fechaPublicacion" => "2013-04-01"
    "aid" => "188"
    "copyright" => "SEP y SEPB"
    "documento" => "simple-article"
    "crossmark" => 0
    "subdocumento" => "cor"
    "cita" => "Rev Psiquiatr Salud Ment. 2013;6:93-4"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2143
      "formatos" => array:3 [
        "EPUB" => 10
        "HTML" => 1665
        "PDF" => 468
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>"
      "titulo" => "Treatment of acute mania with methylphenidate&#58; Therapeutic approach based on a new pathophysiological model"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "93"
          "paginaFinal" => "94"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Tratamiento de la man&#237;a aguda con metilfenidato&#58; propuesta terap&#233;utica basada en un nuevo modelo fisiopatol&#243;gico"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Pilar L&#243;pez-Garc&#237;a, Ulrich Hegerl"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Pilar"
              "apellidos" => "L&#243;pez-Garc&#237;a"
            ]
            1 => array:2 [
              "nombre" => "Ulrich"
              "apellidos" => "Hegerl"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S188898911200184X"
        "doi" => "10.1016/j.rpsm.2012.09.001"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S188898911200184X?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173505012000970?idApp=UINPBA00004N"
    "url" => "/21735050/0000000600000002/v1_201305031504/S2173505012000970/v1_201305031504/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2173505012000945"
    "issn" => "21735050"
    "doi" => "10.1016/j.rpsmen.2012.07.002"
    "estado" => "S300"
    "fechaPublicacion" => "2013-04-01"
    "aid" => "183"
    "copyright" => "SEP y SEPB"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Rev Psiquiatr Salud Ment. 2013;6:80-5"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1908
      "formatos" => array:3 [
        "EPUB" => 9
        "HTML" => 1463
        "PDF" => 436
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Brief report</span>"
      "titulo" => "Burden of disease in adolescents and young people in Spain"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "80"
          "paginaFinal" => "85"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Carga de enfermedad en adolescentes y j&#243;venes en Espa&#241;a"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ferr&#225;n Catal&#225;-L&#243;pez, Ricard G&#232;nova-Maleras, Elena &#193;lvarez-Mart&#237;n, Nerea Fern&#225;ndez de Larrea-Baz, Consuelo Morant-Ginestar"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Ferr&#225;n"
              "apellidos" => "Catal&#225;-L&#243;pez"
            ]
            1 => array:2 [
              "nombre" => "Ricard"
              "apellidos" => "G&#232;nova-Maleras"
            ]
            2 => array:2 [
              "nombre" => "Elena"
              "apellidos" => "&#193;lvarez-Mart&#237;n"
            ]
            3 => array:2 [
              "nombre" => "Nerea"
              "apellidos" => "Fern&#225;ndez de Larrea-Baz"
            ]
            4 => array:2 [
              "nombre" => "Consuelo"
              "apellidos" => "Morant-Ginestar"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1888989112001498"
        "doi" => "10.1016/j.rpsm.2012.07.002"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888989112001498?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173505012000945?idApp=UINPBA00004N"
    "url" => "/21735050/0000000600000002/v1_201305031504/S2173505012000945/v1_201305031504/en/main.assets"
  ]
  "en" => array:18 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Review article</span>"
    "titulo" => "Beliefs about depression and its treatments&#58; Associated variables and the influence of beliefs on adherence to treatment"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "86"
        "paginaFinal" => "92"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Francisco Acosta, Luciano Rodr&#237;guez, Beatriz Cabrera"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "Francisco"
            "apellidos" => "Acosta"
            "email" => array:1 [
              0 => "fjacostaartiles&#64;hotmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Luciano"
            "apellidos" => "Rodr&#237;guez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Beatriz"
            "apellidos" => "Cabrera"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicio de Salud Mental&#44; Direcci&#243;n General de Programas Asistenciales&#44; Gran Canaria&#44; Canarias&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Psiquiatr&#237;a&#44; Hospital Universitario de Gran Canaria Dr&#46; Negr&#237;n&#44; Gran Canaria&#44; Canarias&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Creencias sobre la depresi&#243;n y sus tratamientos&#58; variables asociadas e influencia de las creencias en la adherencia"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Depression is one of the most prevalent and disabling mental disorders in the general population&#44; with substantial consequences at the individual&#44; family and socioeconomic levels&#46; Adherence to treatment is a key factor in recovery for more favourable clinical results later&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> For their part&#44; one&#39;s beliefs about depression and treatment &#40;both psychopharmacological and psychotherapeutic&#41; have been considered as the main variables associated with adherence to antidepressant treatment&#46; In turn&#44; there are multiple determining factors for these beliefs&#44; including sociodemographic and cultural factors and those about the illness itself&#44; among others&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">This review addresses the areas of adherence to antidepressant treatment and psychotherapy&#44; the influence that beliefs and attitudes towards treatment have on adherence&#44; beliefs and attitudes towards depression&#44; psychopharmacological treatment and psychotherapy&#44; as well as its evaluation and limitations in the studies available&#46; It also identifies the most relevant findings of the variables related to these beliefs&#44; although not as an independent section&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Adherence to antidepressant treatment</span><p id="par0015" class="elsevierStylePara elsevierViewall">It has been estimated that non-adherence to antidepressant medication oscillates between 30&#37; and 60&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Among its consequences are increased rate of relapses and recurrences&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> Despite the fact that 49&#8211;84&#37; of the patients perceive the need for antidepressant treatment&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> 1&#47;3 abandon treatment 3 months after feeling better&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> At 6 months&#44; the rate of non-adherence reaches 55&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Strikingly&#44; only 1&#8211;2&#37; of publications dedicated to the treatment of affective disorders explore the factors associated with non-adherence to medication&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Non-adherence is a multifactorial phenomenon&#46; The risk factors have been grouped into several categories&#58; those related to the patient&#44; illness&#44; medication&#44; medical and health care&#44; and family and society&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> The most established factors have been the patient&#39;s attitudes and beliefs about health &#40;including the stigma attached to depression&#41;&#44; the patient&#39;s and family&#39;s attitudes and beliefs about depression and medication&#44; a poor doctor&#8211;patient or psychotherapist&#8211;patient relationship and previous non-adherence&#46; Other factors mentioned are side effects of the medication&#44; lower education and economic level &#40;especially in the early stages of treatment&#41;&#44; not being married&#44; depression itself&#44; forgetfulness&#44; certain personality traits&#44; substance abuse&#44; medical comorbidity and somatoform symptoms&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;8</span></a> Psychoeducation<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> and decision-making in conjunction with the patient<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> are relevant factors for improving adherence&#46; For its part&#44; employment has been associated with a larger social network and a better attitude towards drug treatment and adherence to it&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Both the degree of non-adherence and the risk factors may vary according to the evolutionary moment&#46; Early discontinuation is associated with secondary effects and the perception of medication as ineffective&#46; Patients in the maintenance phase &#40;by definition they are less depressed&#41; reduce their adherence with clinical improvement&#46; Furthermore&#44; they tend to believe that they do not need medication any more or they are less willing to continue tolerating the previously acceptable adverse effects&#44; such as sexual dysfunction&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> For its part&#44; adherence is greater in cases of more severe symptoms&#44; while it predisposes patients not to start treatment in milder cases&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Adherence to psychotherapy</span><p id="par0030" class="elsevierStylePara elsevierViewall">Non-adherence is a prevalent phenomenon in the psychotherapeutic process&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> According to meta-analysis&#44; it falls between 35&#37;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> and 47&#37;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> and may exceed 60&#37; when non-attendance to the first contact appointment is evaluated&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16&#44;17</span></a> In other studies&#44; only 11&#37; completed therapy<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> and only 10&#37; reached the tenth session&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> Non-adherence occurs in all disorders&#44; treatment programmes and therapy types and formats&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">There are very few studies evaluating adherence in psychotherapy&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> Therefore&#44; there are barely any studies on depression<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> and most have focused on socio-demographic characteristics&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Findings on risk factors for non-adherence have been inconclusive&#46; Multiple factors have been encompassed in several areas&#58; patient&#44; therapeutic relationship&#44; context&#44; type of psychotherapy and expectations for therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> However&#44; there is unanimity that the therapeutic relationship&#44; and especially the therapeutic alliance&#44; is a fundamental aspect for adherence&#59; it is also essential&#44; although not itself curative&#44; for the success of psychotherapy&#46;<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">23&#44;24</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">How beliefs and attitudes towards treatment influence adherence</span><p id="par0045" class="elsevierStylePara elsevierViewall">Negative beliefs about medication<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> and illness<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> are an important factor for non-adherence&#46; Positive attitudes regarding antidepressants are associated with more active use of mental health services&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> A positive attitude towards drug therapy was the main predictor of adherence in a prospective study&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> In patients with depression&#44; specific beliefs &#40;such as &#8220;my health depends on antidepressants&#8221;&#41; and less concern about being dependent on this medication have been strongly associated with adherence&#46; Beliefs that drugs cause pain that they are over-prescribed the experience of adverse effects and greater severity of depression were associated with poor adherence&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> The main negative belief found consistently regarding antidepressants was the belief that they can cause addiction&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Other authors did not find an association between the belief that treatment is necessary and better adherence&#44; but an association was found between concern about the medication and non-adherence&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> Positive attitudes towards antidepressants have been associated with the use of antidepressants&#44; with patient education about antidepressants being a mediating variable between the 2&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> In this vein&#44; increased adherence was found in clinical trials in patients receiving advice on treatment&#44; compared to those who did not&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a> Furthermore&#44; positive changes in beliefs about antidepressants have been found in patients who received an intervention programme that included psychoeducation about antidepressant treatment vs the standard systematic follow-up&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a> Patients with greater knowledge on depression and antidepressants and lower perceived stigma adhered better to treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">33</span></a> One of the difficulties in studying stigma and its influence on adherence is differentiating between the stigma associated with antidepressant treatment and that related to depression&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a> The following beliefs have been identified as components of the stigma in patients with depression&#58; that others think the person to be responsible for suffering depression that being near people with depression is not desirable and that these people might constitute a danger&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">35</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Different models have attempted to give coherent explanatory support to the complex interactions among the various factors involved&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Horne&#39;s theoretical model</span> distinguishes between beliefs about medication in general and beliefs about what is specifically prescribed&#46; The latter includes 2 constructs&#58; perceived need for medication &#40;necessity&#41; and perceived potential for medication to cause problems &#40;concern&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">36</span></a> Beliefs about medication in general seem to be most relevant for adherence at the start of treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a> In this acute phase&#44; changes in beliefs about antidepressants occur&#46; Perceptions become more pro-adherence as patients continue to have experience with the treatment&#59; perception of the need for treatment increases and that of harmful potential of drugs weakens&#46; Beliefs in the danger of antidepressants predict the later appearance of side effects&#44; while the occurrence of side effects reinforces the belief of danger&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">38</span></a> In the maintenance phase&#44; the different degrees of adherence are explained by the balance between the perceptions of need and potential harm&#59; adherence is lower when the perceived harm exceeds the perceived need&#44; and higher when the perceived need exceeds the perceived harm&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">The <span class="elsevierStyleItalic">Health Belief Model</span> postulates that the main determinants of the search for treatment and adherence are beliefs about susceptibility to a health problem and its severity&#44; treatment effectiveness&#44; benefits perceived and treatment barriers&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">39</span></a> Such beliefs may be especially important in mental disorders&#44; which are often stigmatized and not well understood&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">40</span></a> Adherence is correlated with the patient&#39;s beliefs about the severity of the disease to be treated or prevented&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> Four states of subjective positioning have been identified according to the &#8220;perceived need&#8221; and &#8220;perception of harm&#8221; in depressed patients&#58; <span class="elsevierStyleItalic">sceptical</span> &#40;those that consider the need for treatment to be low and have high concern for harm related to treatment&#41;&#44; <span class="elsevierStyleItalic">ambivalent</span> &#40;those that perceive high need and worry&#41;&#44; <span class="elsevierStyleItalic">indifferent</span> &#40;those that assess both the need and concern about harm to be low&#41; and <span class="elsevierStyleItalic">accepting</span> &#40;those that perceive a high necessity and low worry&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Beliefs and attitudes towards depression&#44; medication and psychotherapy</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Beliefs about depression</span><p id="par0065" class="elsevierStylePara elsevierViewall">The areas studied have been the aetiology of depression&#44; the usefulness of treatments&#44; the search for help and the perceived stigma&#46; Beliefs about the causes of depression are mostly non-biological&#44; psychological or environmental&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> However&#44; while the general population and patients affected by milder depressive disorders refer to causes or external factors &#40;reactive to interpersonal difficulties and stress&#41;&#44; the more serious patients tend to allude to a biological aetiology and put more trust in drug treatment&#46; For their part&#44; people who suffer from depression tend to have more positive beliefs about treatment than do healthy people&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The most commonly mentioned causes of depression were stress associated with work&#44; followed by personality and family situation&#44; with only 3&#46;6&#37; of the respondents giving biological reasons&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">41</span></a> However&#44; evolution of beliefs about illness origin has been observed in recent years &#40;1996-2006&#41;&#44; the change being directed towards a more biomedical framework&#46; These changes could be justified according to television campaigns with reference to depression&#59; they could also be due to client-directed marketing by pharmaceutical companies in the United States&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">42</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Up to 2&#47;3 of those surveyed in Spain considered depression to be an illness&#44; while the rest considered it a state of mind&#46; Of the same sample&#44; 80&#37; considered it a psychological or mental illness&#46; Furthermore&#44; the respondents unanimously considered depression to be chronic&#46; The causes most frequently indicated were labour&#44; family and economic problems&#44; stress&#44; loss of a loved one and loneliness&#44; confusing triggers with causes&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">43</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Beliefs about depression are factors associated with requesting professional help&#46; The stigma associated with depression is frequent<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">44</span></a>&#59; the beliefs that it is a stigmatizing condition and that one should be able to control one&#39;s own depressive state are associated with concealing symptoms from the doctor&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">45</span></a> The most vulnerable groups would be those of extreme age categories &#40;young people and the elderly&#41;&#44; given the lower perception of illness and the attribution of difficulties to &#8220;normalised&#8221; life phases of the individual&#46; This belief extends even to primary health care doctors&#44; among whom difficulties have been identified for establishing treatment for these groups&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">46</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">Beliefs about the causes of depression influence patients&#8217; treatment preferences&#44; as well as their assignment to 1 type of treatment or another&#46; The preference for psychotherapy is associated with attribution of the aetiology to problems in childhood and to more complex aetiologies&#44; compared to patients who prefer drug treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">47</span></a> Attribution to intra-individual causes is associated with assignment to cognitive behaviour therapy&#44; while attribution to biological causes is associated with psychopharmacological treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">48</span></a> Beliefs in biomedical causes of depression are associated strongly with preference for antidepressant treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">49</span></a> For its part&#44; a belief in non-medical models would interfere with standard biomedical treatment&#44; which would be rejected as of little use or even harmful&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">50</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Beliefs about antidepressants</span><p id="par0085" class="elsevierStylePara elsevierViewall">The main negative beliefs about antidepressants are addictive possibilities &#40;especially in males&#41;&#44; over-medication and prescription abuse of antidepressants&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">51</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">More than 2&#47;3 of the population surveyed in Spain demonstrated beliefs regarding dependency caused by antidepressants&#44; with this being the main adverse effect alleged as the reason for discontinuing the drugs after a short time&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">43</span></a> Similar findings were obtained in older&#44; 60-year-old depressed patients&#44; with negative attitudes towards the treatment&#46; The 2 main reasons for resistance to taking antidepressants were fear of dependence and resistance to seeing depressive symptoms as a medical illness&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">52</span></a> Adolescents preferred psychotherapy over drugs&#44; and the main adverse effects that would make adherence to antidepressant treatment difficult for them were the increase of weight for girls and the sexual effects for boys&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">53</span></a> Patients with major depressive disorder appeared to have a more negative view of antidepressants than those with bipolar disorder&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">54</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Based on Horne&#39;s model&#44; it has been found that the <span class="elsevierStyleItalic">need</span> for antidepressant treatment is associated with older age&#44; greater severity of depressive symptoms&#44; expecting a longer duration of symptoms and attributing the illness to a chemical imbalance&#46; The belief that the treatment is <span class="elsevierStyleItalic">harmful</span> is associated with failing to take antidepressants early&#44; attributing symptoms to random factors and poor understanding of depressive symptoms&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">55</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">It is difficult to differentiate the stigmatizing beliefs related to depression from those related to antidepressants&#46; Resisting or rejecting the use of antidepressants could be a way of avoiding the label of mentally ill&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">56</span></a> In some cases&#44; depression is seen as a sign of weakness&#44; and antidepressants as indicators of the &#8220;mentally weak&#8221; or &#8220;those unable to cope with their emotional problems&#8221;&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">43&#44;57</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Beliefs about psychotherapy vs medication</span><p id="par0105" class="elsevierStylePara elsevierViewall">Preferring psychotherapy to drugs is consistently established in studies of patients with depression&#44; primary care patients and the general population&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> It has been found in the Spanish general population&#44; even in relation to schizophrenia and bipolar disorder&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">58</span></a> The factors associated with this preference include female sex&#44; greater knowledge of psychotherapy or previous experience with it&#44; paid time off and not having been recently treated with antidepressants&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Patients in serious condition also perceive the usefulness of pharmacological and psychotherapeutic co-therapy&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> from which they can learn coping mechanisms and change their thinking patterns&#44; patterns of coping with stress and difficult relationships&#46;<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">59&#44;60</span></a> This preference is maintained today&#44; including in developed countries&#46; However&#44; there has been a gradual rise in positive assessments of psychotropic drugs&#44; coinciding with increased rates of request for assistance from depressed patients&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">61</span></a> Consequently&#44; people familiar with treatment of depression tended to be more willing to recommend seeking help from mental health professionals&#44; and to adopt various treatment options&#44; especially medication&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">62</span></a> This positive correlation in the perceived usefulness of treatment and the possibility of help from mental health professionals appeared more frequently in women&#44;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">63</span></a> in patients without a partner &#40;separated&#44; divorced or widowed&#41;&#44; those who have received prior psychiatric treatment<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">60</span></a> and in patients with a more serious condition&#46; For the general population or patients with a milder illness&#44; higher importance is attributed to the family figure as support and to social workers or counsellors compared to mental health professionals&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The perceived efficiency of these types of treatments is also favourable to psychotherapy in the general population and in primary care patients&#44; especially in the case of males and the elderly population&#46; In the case of depressed patients&#44; studies have been heterogeneous&#44; some favouring psychotherapy and others medication&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Symptoms of cluster B personality disorders have been associated with a negative attitude towards psychotherapy and poor adherence to this treatment in patients with major depression&#44; while symptoms from cluster C personality disorders were associated with a positive attitude&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Assessment</span><p id="par0110" class="elsevierStylePara elsevierViewall">Given the importance of the beliefs and attitudes for adherence&#44; these aspects need to be assessed in all patients&#46; Although the most habitual method will be evaluation in the context of the clinical interview&#44; there are psychometric scales available&#44; some of which are validated in Spain&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Various factors can affect the validity of the attitudes reported by the patient about the medication&#44; such as certain symptoms&#44; stigma and social desirability&#46; Consequently&#44; using simplified interviews&#44; performing the assessment when the patient is stable or has minimal symptoms and avoiding administering stigmatizing assessments &#40;e&#46;g&#46;&#44; a symptom rating scale&#41; have been recommended when assessing adherence&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">64</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">The <span class="elsevierStyleItalic">Beliefs about Medicines Questionnaire</span> &#40;BMQ&#41;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">65</span></a> was designed to evaluate beliefs about medication&#46; It consists of 2 scales&#58; 1 that assesses beliefs about medication in general &#40;BMQ-General&#41; and another scale that evaluates the patient&#39;s opinions on their specific treatment &#40;BMQ-Specific&#41;&#46; There is a validated version in Spain&#46; Its study of psychometric properties&#8212;conducted with chronic&#44; hypertensive&#44; diabetic and university student patients&#8212;showed good validity and reliability&#59; however&#44; it would be advisable to carry out studies in other populations and with other types of treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">66</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">The <span class="elsevierStyleItalic">Drug Attitude Inventory</span> &#40;DAI&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">67</span></a> a widely used scale&#44; was developed for patients with schizophrenia&#44; although it has been used in different psychiatric disorders&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">67</span></a> It assesses attitudes&#44; beliefs and feelings in relation to taking medication&#44; as well as the subjective effect of antipsychotics and illness awareness&#46; The most commonly used version is one which is reduced to 10 items&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">64</span></a> There is a validated version in Spanish&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">68</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">There are other scales&#44; although lacking validation in Spain&#44; such as the <span class="elsevierStyleItalic">Brief Evaluation of Medication Influences and Beliefs</span> &#40;BEMIB&#41;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">69</span></a> and the <span class="elsevierStyleItalic">Rating of Medication Influences</span> &#40;ROMI&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">70</span></a> both based on the Health Belief Model&#46; The <span class="elsevierStyleItalic">Medication Adherence Rating Scale</span> &#40;MARS&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">71</span></a> initially developed for use in patients with schizophrenia and psychosis&#44; assesses adherence and attitudes toward medication&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Study limitations and methodological difficulties</span><p id="par0135" class="elsevierStylePara elsevierViewall">In studying beliefs towards depression and its treatment&#44; questionnaires created by the authors are frequently used&#44; although they are not validated and difficult to repeat&#46; Only some have used validated belief scales such as the <span class="elsevierStyleItalic">Beliefs about Medicines Questionnaire or the Drug Attitude Inventory</span>&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;27&#44;55</span></a> Most studies on adherence have used self-reported measures of adherence&#44; with which its estimation is probably being over evaluated&#44; given that patient-reported adherence is the least valid<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">64</span></a> and tends to be greater than the real figure&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">72</span></a> On the other hand&#44; in the articles reviewed&#44; it is difficult to differentiate those beliefs that refer only to antidepressants from those that refer to psychotropic medications in general&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a> In the same vein&#44; it is difficult to separate the perceived stigma related to depression from that related to antidepressant treatment&#46; With samples of depressed patients&#44; the study of beliefs about depression&#44; its treatment and the variables related to it has the disadvantage that these beliefs may be influenced by the depression itself&#46; The existence of depression&#44; depressive symptoms<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> and the greater severity of these symptoms<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">55</span></a> have been found to influence beliefs about depression and antidepressant treatment&#44; so it is important to have studies that evaluate these beliefs in the absence of depression&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conclusions</span><p id="par0140" class="elsevierStylePara elsevierViewall">Non-adherence is a frequent phenomenon&#44; both in antidepressant treatment and psychotherapy&#44; reaching 30&#8211;60&#37; overall&#46; It is a multifactorial phenomenon and assessing risk factors is essential to address them later&#46; Non-adherence to psychotherapy is still understudied&#46; Beliefs and attitudes towards medication and psychotherapy potentially influence adherence and should be evaluated in all patients&#46; There are multiple causal factors underlying these beliefs and attitudes and they are still understudied&#46; Each patient should be assessed individually&#44; since each person is unique in their personal history and their way of viewing depression and its treatment&#46; Negative beliefs &#40;misconceptions&#44; prejudices&#41;&#44; negative attitudes and possible stigma perceived towards medication and&#47;or depression must be identified and addressed in the context of an appropriate therapeutic relationship&#46; This is because these factors can be important in non-adherence and identifying them and the patient&#39;s preferences may point towards the type of treatment&#46; Overall&#44; there is currently a preference for psychotherapy&#46; However&#44; the positive assessment of psychopharmaceuticals has increased in the last few years&#44; in line with movement towards a biomedical framework regarding beliefs about the aetiology of depression&#46; On the other hand&#44; given that beliefs and attitudes are changeable&#44; influenced by various factors&#44; they should be assessed throughout the evolution of the illness&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Patient beliefs about depression and its treatment are an essential factor for adherence to both psychotherapy and psychotropic drugs and&#44; therefore&#44; for the development of the disorder&#46; The search for the best possible adherence should take place in the context of a good therapeutic relationship&#44; psychoeducation&#44; assessing beliefs and attitudes towards medication and psychotherapy&#44; dealing with any negative beliefs and attitudes and considering patient preferences&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflict of interests</span><p id="par0150" class="elsevierStylePara elsevierViewall">The authors have no conflict of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:13 [
        0 => array:2 [
          "identificador" => "xres114445"
          "titulo" => "Abstract"
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec101759"
          "titulo" => "Keywords"
        ]
        2 => array:2 [
          "identificador" => "xres114444"
          "titulo" => "Resumen"
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec101760"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Adherence to antidepressant treatment"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Adherence to psychotherapy"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "How beliefs and attitudes towards treatment influence adherence"
        ]
        8 => array:3 [
          "identificador" => "sec0025"
          "titulo" => "Beliefs and attitudes towards depression&#44; medication and psychotherapy"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Beliefs about depression"
            ]
            1 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Beliefs about antidepressants"
            ]
            2 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Beliefs about psychotherapy vs medication"
            ]
            3 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Assessment"
            ]
          ]
        ]
        9 => array:2 [
          "identificador" => "sec0050"
          "titulo" => "Study limitations and methodological difficulties"
        ]
        10 => array:2 [
          "identificador" => "sec0055"
          "titulo" => "Conclusions"
        ]
        11 => array:2 [
          "identificador" => "sec0060"
          "titulo" => "Conflict of interests"
        ]
        12 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2012-06-26"
    "fechaAceptado" => "2012-08-29"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec101759"
          "palabras" => array:6 [
            0 => "Beliefs about illness"
            1 => "Antidepressants"
            2 => "Psychotherapy"
            3 => "Treatment"
            4 => "Depression"
            5 => "Treatment adherence"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec101760"
          "palabras" => array:6 [
            0 => "Creencias"
            1 => "Antidepresivos"
            2 => "Psicoterapia"
            3 => "Tratamiento"
            4 => "Depresi&#243;n"
            5 => "Adherencia"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Beliefs and attitudes about treatment in patients with depression are significant factors related to treatment adherence&#46; Despite their importance&#44; few studies have evaluated the determining factors of these beliefs&#44; and the positive or negative attitudes towards treatment&#46; This review looks at areas such as&#44; adherence to antidepressants and psychotherapy&#44; influence of beliefs and attitudes on adherence to treatment&#44; beliefs and attitudes about depression and its treatment&#44; their assessment&#44; variables associated with these beliefs&#44; and limitations of available studies&#46; Acknowledging the importance of patient beliefs about depression and treatment&#44; and their assessment are essential to optimize the chances of success of therapy by identifying and addressing misconceptions&#44; prejudices and negative attitudes&#44; as well as the consideration of these aspects in order to improve treatment choice&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Las creencias y actitudes frente al tratamiento en los pacientes con depresi&#243;n son factores de incuestionable importancia para la adherencia al tratamiento&#46; A pesar de su importancia&#44; a&#250;n existen pocos estudios que hayan evaluado los factores determinantes de las creencias y actitudes negativas o positivas frente al tratamiento&#46; En esta revisi&#243;n se abordan las &#225;reas de la adherencia al tratamiento antidepresivo y a la psicoterapia&#44; la influencia de las creencias y actitudes frente al tratamiento sobre la adherencia&#44; las creencias y actitudes frente a la depresi&#243;n y sus tratamientos&#44; su evaluaci&#243;n&#44; las variables relacionadas con estas creencias&#44; y las limitaciones de los estudios disponibles&#46; La consideraci&#243;n y evaluaci&#243;n de las creencias de los pacientes respecto a la depresi&#243;n y los tratamientos es esencial para optimizar las posibilidades de &#233;xito de la terapia mediante la identificaci&#243;n y abordaje de concepciones err&#243;neas&#44; prejuicios y actitudes negativas&#44; as&#237; como la consideraci&#243;n de estos aspectos en la elecci&#243;n del tratamiento&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara">Please cite this article as&#58; Acosta F&#44; et al&#46; Creencias sobre la depresi&#243;n y sus tratamientos&#58; variables asociadas e influencia de las creencias en la adherencia&#46; Rev Psiquiatr Salud Ment &#40;Barc&#46;&#41;&#46; 2013&#59;6&#58;86&#8211;92&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:72 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effects of adherence to antidepressant treatment guidelines on relapse and recurrence of depression"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46;A&#46; Melfi"
                            1 => "A&#46;J&#46; Chawla"
                            2 => "T&#46;W&#46; Croghan"
                            3 => "M&#46;P&#46; Hanna"
                            4 => "S&#46; Kennedy"
                            5 => "K&#46; Sredl"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Gen Psychiatry"
                        "fecha" => "1998"
                        "volumen" => "55"
                        "paginaInicial" => "1128"
                        "paginaFinal" => "1132"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9862557"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relationship of pharmacologic compliance to long-term prophylaxis in recurrent depression"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46; Frank"
                            1 => "J&#46;M&#46; Perel"
                            2 => "A&#46;G&#46; Mallinger"
                            3 => "M&#46;E&#46; Thase"
                            4 => "D&#46;J&#46; Kupfer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Psychopharmacol Bull"
                        "fecha" => "1992"
                        "volumen" => "28"
                        "paginaInicial" => "231"
                        "paginaFinal" => "235"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1480724"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Health beliefs and perceived need for mental health care of anxiety and depression&#8212;the patients&#8217; perspective explored"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;A&#46; Prins"
                            1 => "P&#46;F&#46;M&#46; Verhaak"
                            2 => "J&#46;M&#46; Bensing"
                            3 => "K&#46; van der Meer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.cpr.2008.02.009"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Psychol Rev"
                        "fecha" => "2008"
                        "volumen" => "28"
                        "paginaInicial" => "1038"
                        "paginaFinal" => "1058"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18420323"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Compliance with antidepressant therapy and antidepressant discontinuation symptoms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "K&#46; Demyttenaere"
                            1 => "P&#46; Haddad"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Psychiatr Scand Suppl"
                        "fecha" => "2000"
                        "volumen" => "403"
                        "paginaInicial" => "50"
                        "paginaFinal" => "56"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11019935"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The compliance with antidepressants in general practice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;C&#46; Maddox"
                            1 => "M&#46; Levi"
                            2 => "C&#46; Thompson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/026988119400800108"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Psychopharmacol"
                        "fecha" => "1994"
                        "volumen" => "8"
                        "paginaInicial" => "48"
                        "paginaFinal" => "52"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22298480"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Persistence and compliance to antidepressant treatment in patients with depression&#58; a chart review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Sawada"
                            1 => "H&#46; Uchida"
                            2 => "T&#46; Suzuki"
                            3 => "K&#46; Watanabe"
                            4 => "T&#46; Kikuchi"
                            5 => "T&#46; Handa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1471-244X-9-38"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Psychiatry"
                        "fecha" => "2009"
                        "volumen" => "9"
                        "paginaInicial" => "38"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19531229"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment non-adherence in affective disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46; Lingam"
                            1 => "J&#46; Scott"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Psychiatr Scand"
                        "fecha" => "2002"
                        "volumen" => "105"
                        "paginaInicial" => "164"
                        "paginaFinal" => "172"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11939969"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La adherencia en los trastornos afectivos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46; Touri&#241;o Gonz&#225;lez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Cuadernos de Psiquiatr&#237;a Comunitaria"
                        "fecha" => "2009"
                        "volumen" => "9"
                        "paginaInicial" => "49"
                        "paginaFinal" => "66"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Collaborative management to achieve depression treatment guidelines"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "W&#46; Katon"
                            1 => "M&#46; Von Korff"
                            2 => "E&#46; Lin"
                            3 => "G&#46; Simon"
                            4 => "E&#46; Walker"
                            5 => "T&#46; Bush"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Psychiatry"
                        "fecha" => "1997"
                        "volumen" => "58"
                        "numero" => "Suppl&#46; 1"
                        "paginaInicial" => "S20"
                        "paginaFinal" => "S23"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "National Collaborating Centre for Mental Health &#40;UK&#41;&#46; Depression&#58; the treatment and management of depression in adults &#40;Updated edition&#41;&#46; Leicester &#40;UK&#41;&#58; British Psychological Society&#59; 2010 &#40;NICE Clinical Guidelines&#44; N&#46;&#176;&#46; 90&#41;&#46; Available from&#58; <a class="elsevierStyleInterRef" href="http://www.ncbi.nlm.nih.gov/books/NBK63748/">http&#58;&#47;&#47;www&#46;ncbi&#46;nlm&#46;nih&#46;gov&#47;books&#47;NBK63748&#47;</a> &#91;accessed 17 August 2012&#93;&#46;"
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment attitudes and adherence of psychiatric patients with major depressive disorder&#58; a five-year prospective study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "I&#46;A&#46;K&#46; Holma"
                            1 => "K&#46;M&#46; Holma"
                            2 => "T&#46;K&#46; Melartin"
                            3 => "E&#46;T&#46; Isomets&#228;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jad.2010.04.022"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Affect Disord"
                        "fecha" => "2010"
                        "volumen" => "127"
                        "paginaInicial" => "102"
                        "paginaFinal" => "112"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20546916"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adherence to maintenance-phase antidepressant medication as a function of patient beliefs about medication"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;E&#46; Aikens"
                            1 => "D&#46;E&#46; Nease"
                            2 => "D&#46;P&#46; Nau"
                            3 => "M&#46;S&#46; Klinkman"
                            4 => "T&#46;L&#46; Schwenk"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1370/afm.238"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Fam Med"
                        "fecha" => "2005"
                        "volumen" => "3"
                        "paginaInicial" => "23"
                        "paginaFinal" => "30"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15671187"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patients&#8217; perceptions and illness severity at start of antidepressant treatment in general practice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46;C&#46;G&#46; Van Geffen"
                            1 => "E&#46;R&#46; Heerdink"
                            2 => "J&#46;G&#46; Hugtenburg"
                            3 => "F&#46;W&#46; Siero"
                            4 => "A&#46;C&#46;G&#46; Egberts"
                            5 => "R&#46; Van Hulten"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.2042-7174.2010.00035.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Pharm Pract"
                        "fecha" => "2010"
                        "volumen" => "18"
                        "paginaInicial" => "217"
                        "paginaFinal" => "225"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20636673"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A meta-analysis of psychotherapy dropout"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46; Wierzbicki"
                            1 => "G&#46; Pekarik"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Prof Psychol Res Pr"
                        "fecha" => "1993"
                        "volumen" => "24"
                        "paginaInicial" => "190"
                        "paginaFinal" => "195"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Psychotherapy dropout&#58; a meta-analytic review of premature termination"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Sharf"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Diss Abstr Int&#58; B&#58; Sci Eng"
                        "fecha" => "2008"
                        "volumen" => "68"
                        "paginaInicial" => "6336"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Better compliance&#58; physicians making it happen"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46;M&#46; Bachman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am Fam Phys"
                        "fecha" => "1993"
                        "volumen" => "48"
                        "paginaInicial" => "717"
                        "paginaFinal" => "718"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factors involved in failure to keep initial appointments with mental health professionals"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "I&#46;R&#46; Nicholson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Hosp Community Psychiatry"
                        "fecha" => "1994"
                        "volumen" => "45"
                        "paginaInicial" => "276"
                        "paginaFinal" => "278"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8188204"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Therapy termination and persistence patterns of elderly clients in a community mental health center"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46;M&#46; Mosher-Ashley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "The Gerontologist"
                        "fecha" => "1994"
                        "volumen" => "34"
                        "paginaInicial" => "180"
                        "paginaFinal" => "189"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8005490"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Brief psychodynamic individual psychotherapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H&#46; Levenson"
                            1 => "S&#46; Butler"
                            2 => "E&#46; Bein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:2 [
                        "titulo" => "Textbook of psychiatry"
                        "serieFecha" => "2002"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neurotic patients who terminate their own treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "H&#46; Roberts"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Psychiatry"
                        "fecha" => "1985"
                        "volumen" => "146"
                        "paginaInicial" => "442"
                        "paginaFinal" => "445"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4016449"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predictors of compliance with psychological interventions offered in the community"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;L&#46; Ayuso-Mateos"
                            1 => "A&#46; Pereda"
                            2 => "G&#46; Dunn"
                            3 => "J&#46;L&#46; V&#225;zquez-Barquero"
                            4 => "P&#46; Casey"
                            5 => "V&#46; Lehtinen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1017/S0033291706009317"
                      "Revista" => array:6 [
                        "tituloSerie" => "Psychol Med"
                        "fecha" => "2007"
                        "volumen" => "37"
                        "paginaInicial" => "717"
                        "paginaFinal" => "725"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17094818"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effectiveness of psychotherapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;J&#46; Lambert"
                            1 => "D&#46;A&#46; Shapiro"
                            2 => "A&#46;E&#46; Bergin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Handbook of psychotherapy and behavior change"
                        "paginaInicial" => "157"
                        "paginaFinal" => "212"
                        "serieFecha" => "1986"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relation between working alliance and outcome in psychotherapy&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46;O&#46; Horvath"
                            1 => "B&#46;D&#46; Symonds"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Couns Psychol"
                        "fecha" => "1991"
                        "volumen" => "38"
                        "paginaInicial" => "139"
                        "paginaFinal" => "149"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La alianza terap&#233;utica&#58; historia&#44; investigaci&#243;n y evaluaci&#243;n"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Corbella"
                            1 => "L&#46; Botella"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Anales de psicolog&#237;a &#40;Murcia&#44; Spain&#41;"
                        "fecha" => "2003"
                        "volumen" => "19"
                        "paginaInicial" => "205"
                        "paginaFinal" => "221"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Health beliefs&#44; disease severity&#44; and patient adherence&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;R&#46; DiMatteo"
                            1 => "K&#46;B&#46; Haskard"
                            2 => "S&#46;L&#46; Williams"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MLR.0b013e318032937e"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Care"
                        "fecha" => "2007"
                        "volumen" => "45"
                        "paginaInicial" => "521"
                        "paginaFinal" => "528"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17515779"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Personal stigma and use of mental health services among people with depression in a general population in Finland"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46; Aromaa"
                            1 => "A&#46; Tolvanen"
                            2 => "J&#46; Tuulari"
                            3 => "K&#46; Wahlbeck"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1471-244X-11-52"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Psychiatry"
                        "fecha" => "2011"
                        "volumen" => "11"
                        "paginaInicial" => "52"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21453504"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nontricyclic antidepressants&#58; predictors of nonadherence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "O&#46;H&#46; Brook"
                            1 => "H&#46;P&#46;J&#46; Van Hout"
                            2 => "W&#46;A&#46;B&#46; Stalman"
                            3 => "M&#46; De Haan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.jcp.0000246217.34024.53"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Psychopharmacol"
                        "fecha" => "2006"
                        "volumen" => "26"
                        "paginaInicial" => "643"
                        "paginaFinal" => "647"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17110823"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Beliefs about medications predict adherence to antidepressants in older adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "W&#46; Fawzi"
                            1 => "M&#46;Y&#46; Abdel Mohsen"
                            2 => "A&#46;H&#46; Hashem"
                            3 => "S&#46; Moussa"
                            4 => "E&#46; Coker"
                            5 => "K&#46;C&#46;M&#46; Wilson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1017/S1041610211001049"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int Psychogeriatr"
                        "fecha" => "2012"
                        "volumen" => "24"
                        "paginaInicial" => "159"
                        "paginaFinal" => "169"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21729414"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Medication beliefs and adherence to antidepressants in primary care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Russell"
                            1 => "N&#46; Kazantzis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "N Z Med J"
                        "fecha" => "2008"
                        "volumen" => "121"
                        "paginaInicial" => "14"
                        "paginaFinal" => "20"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19098944"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mediating roles of adherence attitude and patient education on antidepressant use in patients with depression"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "G&#46;-C&#46; Sun"
                            1 => "M&#46;-C&#46; Hsu"
                            2 => "W&#46; Moyle"
                            3 => "M&#46;-F&#46; Lin"
                            4 => "D&#46; Creedy"
                            5 => "L&#46; Venturato"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1744-6163.2010.00257.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Perspect Psychiatr Care"
                        "fecha" => "2011"
                        "volumen" => "47"
                        "paginaInicial" => "13"
                        "paginaFinal" => "22"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21418069"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of antidepressant drug counselling and information leaflets on adherence to drug treatment in primary care&#58; randomised controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46; Peveler"
                            1 => "C&#46; George"
                            2 => "A&#46;L&#46; Kinmonth"
                            3 => "M&#46; Campbell"
                            4 => "C&#46; Thompson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "1999"
                        "volumen" => "319"
                        "paginaInicial" => "612"
                        "paginaFinal" => "615"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10473477"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Improving patients&#8217; beliefs about antidepressants in primary care&#58; a cluster-randomized controlled trial of the effect of a depression care program"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;C&#46; Vergouwen"
                            1 => "H&#46; Burger"
                            2 => "T&#46;J&#46; Verheij"
                            3 => "F&#46; Koerselman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Prim Care Companion J Clin Psychiatry"
                        "fecha" => "2009"
                        "volumen" => "11"
                        "paginaInicial" => "48"
                        "paginaFinal" => "52"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19617933"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The development and psychometric assessment of an instrument to measure attitudes towards depression and its treatments in patients suffering from non-psychotic depression"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Gabriel"
                            1 => "C&#46; Violato"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jad.2009.11.009"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Affect Disord"
                        "fecha" => "2010"
                        "volumen" => "124"
                        "paginaInicial" => "241"
                        "paginaFinal" => "249"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19944465"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Perceptions of and attitudes toward antidepressants&#58; stigma attached to their use&#8212;a review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Castaldelli-Maia"
                            1 => "L&#46;B&#46; Scomparini"
                            2 => "A&#46;G&#46; De Andrade"
                            3 => "D&#46; Bhugra"
                            4 => "T&#46;C&#46; De Toledo Ferraz &#193;lves"
                            5 => "G&#46; D&#8217;Elia"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/NMD.0b013e3182388950"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Nerv Ment Dis"
                        "fecha" => "2011"
                        "volumen" => "199"
                        "paginaInicial" => "866"
                        "paginaFinal" => "871"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22048139"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Exploring the nature of stigmatising beliefs about depression and help-seeking&#58; implications for reducing stigma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;J&#46; Barney"
                            1 => "K&#46;M&#46; Griffiths"
                            2 => "H&#46; Christensen"
                            3 => "A&#46;F&#46; Jorm"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1471-2458-9-61"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Public Health"
                        "fecha" => "2009"
                        "volumen" => "9"
                        "paginaInicial" => "61"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19228435"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment perception and self-regulation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46;E&#46; Horne"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "The self-regulation of health and illness behaviour"
                        "paginaInicial" => "138"
                        "paginaFinal" => "153"
                        "serieFecha" => "2003"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of the primary care physician in patients&#8217; adherence to antidepressant therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46;H&#46; Lin"
                            1 => "M&#46; Von Korff"
                            2 => "W&#46; Katon"
                            3 => "T&#46; Bush"
                            4 => "G&#46;E&#46; Simon"
                            5 => "E&#46; Walker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Care"
                        "fecha" => "1995"
                        "volumen" => "33"
                        "paginaInicial" => "67"
                        "paginaFinal" => "74"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7823648"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Changes in patients&#8217; beliefs about their antidepressant during the acute phase of depression treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;E&#46; Aikens"
                            1 => "M&#46;S&#46; Klinkman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.genhosppsych.2012.01.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Gen Hosp Psychiatry"
                        "fecha" => "2012"
                        "volumen" => "34"
                        "paginaInicial" => "221"
                        "paginaFinal" => "226"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22325627"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The health belief model&#58; a decade later"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "N&#46;K&#46; Janz"
                            1 => "M&#46;H&#46; Becker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Health Educ Q"
                        "fecha" => "1984"
                        "volumen" => "11"
                        "paginaInicial" => "1"
                        "paginaFinal" => "47"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6392204"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Beliefs about depression and depression treatment among depressed veterans"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;J&#46; Edlund"
                            1 => "J&#46;C&#46; Fortney"
                            2 => "C&#46;M&#46; Reaves"
                            3 => "J&#46;M&#46; Pyne"
                            4 => "D&#46; Mittal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MLR.0b013e3181648e46"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Care"
                        "fecha" => "2008"
                        "volumen" => "46"
                        "paginaInicial" => "581"
                        "paginaFinal" => "589"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18520312"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "41"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patients&#8217; beliefs about the cause of their depression"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Hansson"
                            1 => "J&#46; Chotai"
                            2 => "O&#46; Bodlund"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jad.2009.10.032"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Affect Disord"
                        "fecha" => "2010"
                        "volumen" => "124"
                        "paginaInicial" => "54"
                        "paginaFinal" => "59"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19923007"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "42"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Changing perceptions of depression&#58; ten-year trends from the general social survey"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "K&#46;H&#46; Blumner"
                            1 => "S&#46;C&#46; Marcus"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1176/appi.ps.60.3.306"
                      "Revista" => array:6 [
                        "tituloSerie" => "Psychiatr Serv"
                        "fecha" => "2009"
                        "volumen" => "60"
                        "paginaInicial" => "306"
                        "paginaFinal" => "312"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19252042"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "43"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Knowledge and perception about depression in the Spanish population"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Comas"
                            1 => "E&#46; &#193;lvarez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Esp Psiquiatr"
                        "fecha" => "2004"
                        "volumen" => "32"
                        "paginaInicial" => "371"
                        "paginaFinal" => "376"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15529227"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            43 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "44"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Stigma and depression among primary care patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46; Roeloffs"
                            1 => "C&#46; Sherbourne"
                            2 => "J&#46; Un&#252;tzer"
                            3 => "A&#46; Fink"
                            4 => "L&#46; Tang"
                            5 => "K&#46;B&#46; Wells"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Gen Hosp Psychiatry"
                        "fecha" => "2003"
                        "volumen" => "25"
                        "paginaInicial" => "311"
                        "paginaFinal" => "315"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12972221"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            44 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "45"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Suffering in silence&#58; reasons for not disclosing depression in primary care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;A&#46; Bell"
                            1 => "P&#46; Franks"
                            2 => "P&#46;R&#46; Duberstein"
                            3 => "R&#46;M&#46; Epstein"
                            4 => "M&#46;D&#46; Feldman"
                            5 => "E&#46; Garc&#237;a"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1370/afm.1277"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Fam Med"
                        "fecha" => "2011"
                        "volumen" => "9"
                        "paginaInicial" => "439"
                        "paginaFinal" => "446"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21911763"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            45 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "46"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Justifiable depression&#58; how primary care professionals and patients view late-life depression&#63; A qualitative study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "H&#46; Burroughs"
                            1 => "K&#46; Lovell"
                            2 => "M&#46; Morley"
                            3 => "R&#46; Baldwin"
                            4 => "A&#46; Burns"
                            5 => "C&#46; Chew-Graham"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/fampra/cmi115"
                      "Revista" => array:6 [
                        "tituloSerie" => "Fam Pract"
                        "fecha" => "2006"
                        "volumen" => "23"
                        "paginaInicial" => "369"
                        "paginaFinal" => "377"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16476699"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            46 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "47"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Beliefs about the causes of depression and treatment preferences"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46;R&#46; Khalsa"
                            1 => "K&#46;S&#46; McCarthy"
                            2 => "B&#46;A&#46; Sharpless"
                            3 => "M&#46;S&#46; Barrett"
                            4 => "J&#46;P&#46; Barber"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jclp.20785"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Psychol"
                        "fecha" => "2011"
                        "volumen" => "67"
                        "paginaInicial" => "539"
                        "paginaFinal" => "549"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21365652"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            47 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "48"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Does illness attribution affect treatment assignment in depression&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Schweizer"
                            1 => "F&#46; Peeters"
                            2 => "M&#46; Huibers"
                            3 => "J&#46; Roelofs"
                            4 => "J&#46; Van Os"
                            5 => "A&#46; Arntz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/cpp.662"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Psychol Psychother"
                        "fecha" => "2010"
                        "volumen" => "17"
                        "paginaInicial" => "418"
                        "paginaFinal" => "426"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19911389"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            48 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "49"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Depression treatment preferences of Hispanic individuals&#58; exploring the influence of ethnicity&#44; language&#44; and explanatory models"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Y&#46; Fern&#225;ndez"
                            1 => "E&#46; Garc&#237;a"
                            2 => "P&#46; Franks"
                            3 => "A&#46; Jerant"
                            4 => "R&#46;A&#46; Bell"
                            5 => "R&#46;L&#46; Kravitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3122/jabfm.2011.01.100118"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Board Fam Med"
                        "fecha" => "2011"
                        "volumen" => "24"
                        "paginaInicial" => "39"
                        "paginaFinal" => "50"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21209343"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            49 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "50"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patient attitudes regarding causes of depression&#58; implications for psychoeducation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Srinivasan"
                            1 => "N&#46;L&#46; Cohen"
                            2 => "S&#46;V&#46; Parikh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Can J Psychiatry"
                        "fecha" => "2003"
                        "volumen" => "48"
                        "paginaInicial" => "493"
                        "paginaFinal" => "495"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12971021"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            50 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "51"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Beliefs about antidepressant medications in primary care patients&#58; relationship to self-reported adherence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46; Brown"
                            1 => "D&#46;R&#46; Battista"
                            2 => "R&#46; Bruehlman"
                            3 => "S&#46;S&#46; Sereika"
                            4 => "M&#46;E&#46; Thase"
                            5 => "J&#46; Dunbar-Jacob"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Care"
                        "fecha" => "2005"
                        "volumen" => "43"
                        "paginaInicial" => "1203"
                        "paginaFinal" => "1207"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16299431"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            51 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "52"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Older patients&#8217; aversion to antidepressants&#46; A qualitative study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;L&#46; Givens"
                            1 => "C&#46;J&#46; Datto"
                            2 => "K&#46; Ruckdeschel"
                            3 => "K&#46; Knott"
                            4 => "C&#46; Zubritsky"
                            5 => "D&#46;W&#46; Oslin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1525-1497.2005.00296.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Gen Intern Med"
                        "fecha" => "2006"
                        "volumen" => "21"
                        "paginaInicial" => "146"
                        "paginaFinal" => "151"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16336620"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            52 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "53"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adolescents&#8217; attitudes and opinions about depression treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46;L&#46; Bradley"
                            1 => "P&#46;J&#46; McGrath"
                            2 => "C&#46;L&#46; Brannen"
                            3 => "A&#46;L&#46; Bagnell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10597-009-9224-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "Community Ment Health J"
                        "fecha" => "2010"
                        "volumen" => "46"
                        "paginaInicial" => "242"
                        "paginaFinal" => "251"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19636707"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            53 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "54"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Depressive and bipolar disorders&#58; patients&#8217; attitudes and beliefs towards depression and antidepressants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;V&#46; Kessing"
                            1 => "H&#46;V&#46; Hansen"
                            2 => "K&#46; Demyttenaere"
                            3 => "P&#46; Bech"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Psychol Med"
                        "fecha" => "2005"
                        "volumen" => "35"
                        "paginaInicial" => "1205"
                        "paginaFinal" => "1213"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16116946"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            54 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "55"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Explaining patients&#8217; beliefs about the necessity and harmfulness of antidepressants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;E&#46; Aikens"
                            1 => "D&#46;E&#46; Nease"
                            2 => "M&#46;S&#46; Klinkman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1370/afm.759"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Fam Med"
                        "fecha" => "2008"
                        "volumen" => "6"
                        "paginaInicial" => "23"
                        "paginaFinal" => "29"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18195311"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            55 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "56"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#8220;Medication career&#8221; or &#8220;moral career&#8221;&#63; The two sides of managing antidepressants&#58; a meta-ethnography of patients&#8217; experience of antidepressants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Malpass"
                            1 => "A&#46; Shaw"
                            2 => "D&#46; Sharp"
                            3 => "F&#46; Walter"
                            4 => "G&#46; Feder"
                            5 => "M&#46; Ridd"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.socscimed.2008.09.068"
                      "Revista" => array:6 [
                        "tituloSerie" => "Soc Sci Med"
                        "fecha" => "2009"
                        "volumen" => "68"
                        "paginaInicial" => "154"
                        "paginaFinal" => "168"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19013702"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            56 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "57"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A qualitative analysis of the perception of stigma among Latinos receiving antidepressants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Interian"
                            1 => "I&#46;E&#46; Mart&#237;nez"
                            2 => "P&#46;J&#46; Guarnaccia"
                            3 => "W&#46;A&#46; Vega"
                            4 => "J&#46;I&#46; Escobar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1176/ps.2007.58.12.1591"
                      "Revista" => array:6 [
                        "tituloSerie" => "Psychiatr Serv"
                        "fecha" => "2007"
                        "volumen" => "58"
                        "paginaInicial" => "1591"
                        "paginaFinal" => "1594"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18048562"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            57 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "58"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Opinions and beliefs of the Spanish population on serious mental illnesses &#40;schizophrenia and bipolar disorder&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;&#193;&#46; Ruiz"
                            1 => "J&#46;M&#46; Montes"
                            2 => "J&#46; Correas Lauffer"
                            3 => "C&#46; &#193;lvarez"
                            4 => "J&#46; Mauri&#241;o"
                            5 => "C&#46; De Dios Perrino"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rpsm.2012.01.002"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Psiquiatr Salud Ment"
                        "fecha" => "2012"
                        "volumen" => "5"
                        "paginaInicial" => "98"
                        "paginaFinal" => "106"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22854580"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            58 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "59"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessing patient beliefs in a clinical trial of <span class="elsevierStyleItalic">Hypericum perforatum</span> in major depression"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46;M&#46; Bann"
                            1 => "C&#46;B&#46; Parker"
                            2 => "J&#46; Bradwejn"
                            3 => "J&#46;R&#46;T&#46; Davidson"
                            4 => "B&#46; Vitiello"
                            5 => "K&#46;M&#46; Gadde"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/da.20036"
                      "Revista" => array:6 [
                        "tituloSerie" => "Depress Anxiety"
                        "fecha" => "2004"
                        "volumen" => "20"
                        "paginaInicial" => "114"
                        "paginaFinal" => "122"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15549690"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            59 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "60"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The acceptability of treatment for depression among African-American Hispanic&#44; and white primary care patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46;A&#46; Cooper"
                            1 => "J&#46;J&#46; Gonzales"
                            2 => "J&#46;J&#46; Gallo"
                            3 => "K&#46;M&#46; Rost"
                            4 => "L&#46;S&#46; Meredith"
                            5 => "L&#46;V&#46; Rubenstein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.MLR.0000053228.58042.E4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Care"
                        "fecha" => "2003"
                        "volumen" => "41"
                        "paginaInicial" => "479"
                        "paginaFinal" => "489"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12665712"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            60 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "61"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Public belief systems about the helpfulness of interventions for depression&#58; associations with history of depression and professional help-seeking"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46;F&#46; Jorm"
                            1 => "H&#46; Christensen"
                            2 => "J&#46; Medway"
                            3 => "A&#46;E&#46; Korten"
                            4 => "P&#46;A&#46; Jacomb"
                            5 => "B&#46; Rodgers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Soc Psychiatry Psychiatr Epidemiol"
                        "fecha" => "2000"
                        "volumen" => "35"
                        "paginaInicial" => "211"
                        "paginaFinal" => "219"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10941996"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            61 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "62"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "What to do about depression&#63; Help-seeking and treatment recommendations of the public"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Holzinger"
                            1 => "H&#46; Matschinger"
                            2 => "M&#46;C&#46; Angermeyer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Epidemiol Psychiatr Sci"
                        "fecha" => "2011"
                        "volumen" => "20"
                        "paginaInicial" => "163"
                        "paginaFinal" => "169"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21714363"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            62 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "63"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Depression treatment preferences in younger and older adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46;D&#46; Rokke"
                            1 => "F&#46; Scogin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Clin Geropsychol"
                        "fecha" => "1995"
                        "volumen" => "1"
                        "paginaInicial" => "243"
                        "paginaFinal" => "257"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            63 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "64"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Measurement of psychiatric treatment adherence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Sajatovic"
                            1 => "D&#46;I&#46; Velligan"
                            2 => "P&#46;J&#46; Weiden"
                            3 => "M&#46;A&#46; Valenstein"
                            4 => "G&#46; Ogedegbe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jpsychores.2009.05.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Psychosom Res"
                        "fecha" => "2010"
                        "volumen" => "69"
                        "paginaInicial" => "591"
                        "paginaFinal" => "599"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21109048"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            64 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "65"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The beliefs about medicines questionnaire&#58; the development and evaluation of a new method for assessing the cognitive representation of medication"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Horne"
                            1 => "J&#46; Weinman"
                            2 => "M&#46; Hankins"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Psychol Health"
                        "fecha" => "1999"
                        "volumen" => "14"
                        "paginaInicial" => "1"
                        "paginaFinal" => "24"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            65 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "66"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluaci&#243;n de las creencias sobre el tratamiento&#58; validez fiabilidad de la versi&#243;n espa&#241;ola del Beliefs About Medicines Questionnaire"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Bel&#233;ndez V&#225;zquez"
                            1 => "A&#46; Hern&#225;ndez Mijares"
                            2 => "R&#46; Horne"
                            3 => "J&#46; Weinman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Clin Health Psychol"
                        "fecha" => "2007"
                        "volumen" => "7"
                        "paginaInicial" => "767"
                        "paginaFinal" => "779"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            66 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "67"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A self-report scale predictive of drug compliance in schizophrenics&#58; reliability and discriminative validity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46;P&#46; Hogan"
                            1 => "A&#46;G&#46; Awad"
                            2 => "R&#46; Eastwood"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Psychol Med"
                        "fecha" => "1983"
                        "volumen" => "13"
                        "paginaInicial" => "177"
                        "paginaFinal" => "183"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6133297"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            67 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "68"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment of drug attitudes in patients with schizophrenia&#58; psychometric properties of the DAI Spanish version"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Robles Garc&#237;a"
                            1 => "V&#46; Salazar Alvarado"
                            2 => "F&#46; P&#225;ez Agraz"
                            3 => "F&#46; Ram&#237;rez Barreto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Esp Psiquiatr"
                        "fecha" => "2004"
                        "volumen" => "32"
                        "paginaInicial" => "138"
                        "paginaFinal" => "142"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15168263"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            68 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "69"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Brief evaluation of medication influences and beliefs&#58; development and testing of a brief scale for medication adherence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46;R&#46; Dolder"
                            1 => "J&#46;P&#46; Lacro"
                            2 => "K&#46;A&#46; Warren"
                            3 => "S&#46; Golshan"
                            4 => "D&#46;O&#46; Perkins"
                            5 => "D&#46;V&#46; Jeste"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Psychopharmacol"
                        "fecha" => "2004"
                        "volumen" => "24"
                        "paginaInicial" => "404"
                        "paginaFinal" => "409"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15232332"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            69 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "70"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rating of medication influences &#40;ROMI&#41; scale in schizophrenia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Weiden"
                            1 => "B&#46; Rapkin"
                            2 => "T&#46; Mott"
                            3 => "A&#46; Zygmunt"
                            4 => "D&#46; Goldman"
                            5 => "M&#46; Horvitz-Lennon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Schizophr Bull"
                        "fecha" => "1994"
                        "volumen" => "20"
                        "paginaInicial" => "297"
                        "paginaFinal" => "310"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7916162"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            70 => array:3 [
              "identificador" => "bib0355"
              "etiqueta" => "71"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reliability and validity of a new Medication Adherence Rating Scale &#40;MARS&#41; for the psychoses"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "K&#46; Thompson"
                            1 => "J&#46; Kulkarni"
                            2 => "A&#46;A&#46; Sergejew"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Schizophr Res"
                        "fecha" => "2000"
                        "volumen" => "42"
                        "paginaInicial" => "241"
                        "paginaFinal" => "247"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10785582"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            71 => array:3 [
              "identificador" => "bib0360"
              "etiqueta" => "72"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of noncompliance in schizophrenia patients using electronic monitoring &#40;MEMS&#41; and its relationship to sociodemographic&#44; clinical and psychopathological variables"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "F&#46;J&#46; Acosta"
                            1 => "E&#46; Bosch"
                            2 => "G&#46; Sarmiento"
                            3 => "N&#46; Juanes"
                            4 => "A&#46; Caballero-Hidalgo"
                            5 => "T&#46; Mayans"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.schres.2008.09.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Schizophr Res"
                        "fecha" => "2009"
                        "volumen" => "107"
                        "paginaInicial" => "213"
                        "paginaFinal" => "217"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18849150"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735050/0000000600000002/v1_201305031504/S2173505012000957/v1_201305031504/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "7615"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Review article"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735050/0000000600000002/v1_201305031504/S2173505012000957/v1_201305031504/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173505012000957?idApp=UINPBA00004N"
]

Article information

ISSN: 21735050
Original language: English

DOI:10.1016/j.rpsmen.2012.08.002

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	13	6	19
2024 October	72	16	88
2024 September	58	12	70
2024 August	60	6	66
2024 July	57	8	65
2024 June	44	7	51
2024 May	49	9	58
2024 April	56	9	65
2024 March	80	18	98
2024 February	94	10	104
2024 January	111	7	118
2023 December	97	26	123
2023 November	100	9	109
2023 October	98	16	114
2023 September	55	9	64
2023 August	70	7	77
2023 July	126	11	137
2023 June	95	9	104
2023 May	130	11	141
2023 April	139	13	152
2023 March	140	8	148
2023 February	79	13	92
2023 January	88	18	106
2022 December	92	26	118
2022 November	83	27	110
2022 October	72	30	102
2022 September	73	26	99
2022 August	70	22	92
2022 July	52	13	65
2022 June	61	24	85
2022 May	59	18	77
2022 April	69	31	100
2022 March	85	17	102
2022 February	64	7	71
2022 January	112	14	126
2021 December	95	25	120
2021 November	89	26	115
2021 October	146	53	199
2021 September	56	16	72
2021 August	70	10	80
2021 July	41	10	51
2021 June	57	14	71
2021 May	66	16	82
2021 April	156	18	174
2021 March	61	18	79
2021 February	66	16	82
2021 January	61	17	78
2020 December	63	9	72
2020 November	94	16	110
2020 October	213	6	219
2020 September	49	22	71
2020 August	59	11	70
2020 July	55	16	71
2020 June	36	11	47
2020 May	55	11	66
2020 April	46	5	51
2020 March	58	12	70
2020 February	81	21	102
2020 January	58	16	74
2019 December	68	17	85
2019 November	50	12	62
2019 October	49	6	55
2019 September	84	10	94
2019 August	52	11	63
2019 July	70	36	106
2019 June	46	12	58
2019 May	60	39	99
2019 April	87	44	131
2019 March	38	15	53
2019 February	37	6	43
2019 January	36	22	58
2018 December	29	8	37
2018 November	24	10	34
2018 October	41	10	51
2018 September	24	3	27
2018 August	23	4	27
2018 July	23	2	25
2018 June	17	4	21
2018 May	21	12	33
2018 April	16	4	20
2018 March	12	2	14
2018 February	9	4	13
2018 January	11	6	17
2017 December	16	6	22
2017 November	12	4	16
2017 October	16	5	21
2017 September	11	6	17
2017 August	9	3	12
2017 July	30	4	34
2017 June	34	20	54
2017 May	32	3	35
2017 April	32	25	57
2017 March	39	13	52
2017 February	24	2	26
2017 January	25	7	32
2016 December	40	4	44
2016 November	23	7	30
2016 October	27	6	33
2016 September	38	10	48
2016 August	27	10	37
2016 July	23	4	27
2016 June	22	17	39
2016 May	36	19	55
2016 April	22	17	39
2016 March	33	20	53
2016 February	28	18	46
2016 January	23	14	37
2015 December	27	11	38
2015 November	21	17	38
2015 October	23	8	31
2015 September	18	5	23
2015 August	17	5	22
2015 July	12	3	15
2015 June	9	3	12
2015 May	13	6	19
2015 April	21	12	33
2015 March	20	8	28
2015 February	19	5	24
2015 January	34	4	38
2014 December	47	7	54
2014 November	23	6	29
2014 October	26	6	32
2014 September	21	4	25
2014 August	24	3	27
2014 July	30	2	32
2014 June	20	5	25
2014 May	27	8	35
2014 April	18	6	24
2014 March	21	4	25
2014 February	14	9	23
2014 January	21	4	25
2013 December	28	5	33
2013 November	23	9	32
2013 October	21	6	27
2013 September	37	7	44
2013 August	45	10	55
2013 July	33	9	42

Show all

Indexed in:

Follow us:

Statistics

Indexed in:

Follow us:

Statistics

Subscribe to our newsletter