Checking the plausibility of psychiatrists׳ arguments for not prescribing depot medication

Treatment with long-acting depot antipsychotics may yield beneficial effects with regard to long-term adherence and long term outcomes in patients with schizophrenia. However, the implementation of depot treatment is rather low in many settings. Research on this issue helped identifying various potential reasons for this pattern including patient refusal and negative attitudes of psychiatrists. Nevertheless no definite conclusion exists as to what actually hinders the wider implementation of depot treatment. To date there are no studies that surveyed this issue with regard to concrete patients and from both perspectives, of the psychiatrists and the related patients. In the present analysis we therefore analyzed psychiatrists׳ and patients׳ behavior regarding depot prescription in N=213 individual doctor-inpatient-dyads in German psychiatric hospitals. A high number of patients (30%) were actually prescribed depot at discharge, even more were informed about the possibility of depot treatment by their psychiatrists (47%). Moreover, 50% of the surveyed patients were generally open toward receiving depot antipsychotics. However, for the high number of patients not receiving depot (70%) the psychiatrists׳ arguments against depot were often implausible and therefore many more patients might be suitable for receiving depot treatment. Psychiatrists׳ hesitation to discuss and implement depot might also be founded in concerns regarding patients׳ acceptance of depot medication. Here doctors should be empowered by teaching communication strategies that may help to convince patients accept treatment.