Relationships between the Ukrainian Public’s Awareness of Psychotropic Drugs, Stigmatizing People Taking Psychotropic Drugs and Stopping Psychotropic Drug Medication without Consulting with a Doctor

The purpose of the study was to outline possible relationships between public awareness of psychotropic drugs, stigmatization of people suffering from mental disorders and discontinuation of drugs without consultation with a doctor in Ukraine. Materials and methods. This study is based on the analysis of data obtained through an electronic questionnaire filled out by the Ukrainian public. Until April 2021 the questionnaire was freely available to everyone who wanted to take part in the survey. The questionnaire was distributed via an Internet link. Based on the obtained data, the respondents were divided into different categories depending on their education, profession (a medical worker was analyzed separately). Also, the respondents who had personal experience of using psychotropic drugs were interviewed especially deeply and in more details, depending on which group of drugs they used (antidepressants / antipsychotics / anxiolytics). The separate place in the study was given to identifying the general awareness of the Ukrainian public about correct and erroneous judgments about psychotropic drugs. Results and discussion. Based on the obtained data, main factors which are influencing people awareness of psychotropic drugs were identified, as well as the approximate percentage of citizens with erroneous judgments about psychotropic drugs. Thanks to the results of the questionnaire, the main possible reasons for the withdrawal of treatment with psychotropic drugs by patients without consultation with the attending physician were suggested (identified). Conclusion. It can be concluded from the obtained data that a person’s awareness in the field of psychotropic drugs is most influenced by their own experience of their use. For this reason, the author would be interested to know how psychiatric patients are informed by their physicians. The author is aware that the amount of data obtained is not completely sufficient to create a significant picture of the general situation, but she hopes that the obtained data will still allow to get some idea of the situation as a whole. In conclusion, not only the obtained results in this study were outlined, but also possible further actions to obtain a more accurate picture of the situation were mentioned, and the topic of the next study was indicated in order to solve the identified problem.

Relationships between the Ukrainian Public's Awareness of Psychotropic Drugs, Stigmatizing People Taking Psychotropic Drugs and Stopping Psychotropic Drug Medication without Consulting with a Doctor

University of Medicine in Prague, Czech Republic
The purpose of the study was to outline possible relationships between public awareness of psychotropic drugs, stigmatization of people suffering from mental disorders and discontinuation of drugs without consultation with a doctor in Ukraine.
Materials and methods. This study is based on the analysis of data obtained through an electronic questionnaire filled out by the Ukrainian public. Until April 2021 the questionnaire was freely available to everyone who wanted to take part in the survey. The questionnaire was distributed via an Internet link. Based on the obtained data, the respondents were divided into different categories depending on their education, profession (a medical worker was analyzed separately). Also, the respondents who had personal experience of using psychotropic drugs were interviewed especially deeply and in more details, depending on which group of drugs they used (antidepressants / antipsychotics / anxiolytics). The separate place in the study was given to identifying the general awareness of the Ukrainian public about correct and erroneous judgments about psychotropic drugs.
Results and discussion. Based on the obtained data, main factors which are influencing people awareness of psychotropic drugs were identified, as well as the approximate percentage of citizens with erroneous judgments about psychotropic drugs. Thanks to the results of the questionnaire, the main possible reasons for the withdrawal of treatment with psychotropic drugs by patients without consultation with the attending physician were suggested (identified).
Conclusion. It can be concluded from the obtained data that a person's awareness in the field of psychotropic drugs is most influenced by their own experience of their use. For this reason, the author would be interested to know how psychiatric patients are informed by their physicians. The author is aware that the amount of data obtained is not completely sufficient to create a significant picture of the general situation, but she hopes that the obtained data will still allow to get some idea of the situation as a whole. In conclusion, not only the obtained results in this study were outlined, but also possible further actions to obtain a more accurate picture of the situation were mentioned, and the topic of the next study was indicated in order to solve the identified problem.
Keywords: Ukraine, psychotropic drugs, discontinuation of drugs, stigmatization, awareness of psychotropic drugs.
Introduction. The introduction of psychotropic drugs into clinical practice has been marked as a breakthrough in psychiatry, and since then new, more modern preparations have been appearing on the market, enabling increasingly effective treatment. On the other hand, even today, the stigmatization of people suffering from mental disorders persists and many patients discontinue prescribed drugs without consulting their doctor.
The purpose of the study. In this work, we aim to outline possible relationships between public awareness of psychotropic drugs (hereinafter referred to as awareness), stigmatization of people suffering from mental disorders (hereinafter referred to as stigmatization) and discontinuation of drugs without consultation with a doctor (hereinafter non-adherence) in Ukraine. However, the most space of this article is devoted to possible causes of non-adherence.
Links: 1. https://med-luban.by/polinform/307-chto-takoe-stigma-stigmatizatsiya-samostigmatizatsiya-i-kak-ee-izbezhat.html 2. https://www.healthline.com/health/what-is-apsychotropic-drug 3. https://scielo.isciii.es/scielo.php?script=sci_ arttext&pid=S0213-61632012000400003 Materials and methods. This work is based on the data provided in the questionnaire, which was shared via an Internet link. The link was first shared among users of the social network Facebook, later shared by the Depression & Hope page, and after was shared among users of the social network VKontakte. 462 responses were received, 3 of which were excluded because the answer of the respondent age was not realistic, so these responses were considered as irrelevant. Due to the method of distributing the questionnaire, it was not possible to obtain a representative sample of respondents for the total population of Ukraine. Only about 22% of respondents were men, the average age of the respondent was 28 years old and almost 35% of respondents work or study in the medical field. Then the answers were sorted into different categories and were compared according to the goals of this work. The categories were mainly based on experience with psychotropic drugs and medical education.

Results.
We obtained the largest differences in the answers when divided according to the respondents' experience with psychotropic drugs. The best informed were those who were at that moment taking psychotropic drugs, slightly less those who had been taking them, but who had discontinued them in collaboration with a doctor. Respondents who discontinued medication without consulting a physician were less informed than those who discontinued medication in collaboration with a physician. The least informed were those who had never taken psychotropic drugs.
There were also some differences between the responses of men and women and between health professionals and lay people. However, these differences were not very significant compared to the above distribution. This can be evidenced by the fact that in the group of people who have never used psychotropic drugs, 42% are health professionals and in the group of people who are currently taking psychotropic drugs, only 10%, and yet the answers show a significant impact of their own experience on information.
We also got an overview of how often patients stop taking psychotropic drugs and for what reason. Of those who reported experience with antidepressants (136 people in total), 67% are currently taking them, 10% have discontinued them in collaboration with a doctor and 23% have discontinued them without consulting a doctor. Of those who reported experience with the use of antipsychotics (a total of 41 people), 63% are currently taking it, 7% have discontinued it in cooperation with a doctor and 30% have discontinued it without consulting a doctor. Of those who reported experience with the use of anxiolytics (a total of 80 people), 50% are currently taking it, 14% have discontinued it in cooperation with a doctor and 36% have discontinued it without consulting a doctor.
Respondents who discontinued medication without consultation (72 people were able to provide multiple responses) did not state a reason in 18 cases. Others cited side effects in 10 cases, in 9 cases improved mental state, in 8 cases they tried to minimize the amount of drugs used, in 8 cases they indicated the inability to cooperate with the doctor (antipathy, forgot to use, after taking the package they did not visit the doctor, etc.), in 7 cases they stated that they did not observe any effect, in 6 cases they were convinced that the drug changed their personality, in 4 cases they stated fear of addiction, in 2 cases preg-nancy and no one stated as a reason for the reaction of the environment or persuasion of others.
Respondents did not comment much on openly stigmatizing views. Only 5% of respondents considered the use of psychotropic drugs as a manifestation of weakness or incapacity, 4% of respondents considered persons taking psychotropic drugs to be dangerous and 1% of respondents described persons taking psychotropic drugs as fools. Respondents most often identified people using psychotropic drugs as ill in 80% of responses, and 60% of respondents consider the use of psychotropic drugs to be the result of exposure to excessive stress. A possible connection with non-adherence emerged in these opinions. Respondents who discontinued psychotropic drugs without consulting a physician considered those who use psychotropic drugs to be ill in 69% of cases (least of all groups) and respondents who discontinued psychotropic drugs in cooperation with a physician considered persons who use psychotropic drugs to be ill in 88% of cases (most of all groups).
Two indirectly stigmatizing statements were hidden in the questionnaire in possible questionnaires. The first is about antidepressants, and it says, "They are for people who cannot deal with everyday problems", and attributes weakness or disability to people taking antidepressants. This statement was signed as a true one by 14% of all respondents and in the group of respondents who stopped psychotropic drugs without consulting a doctor, even 28%. The second statement, which concerned antipsychotics, was "They do not solve the patient's illness, but only keep the patient in a subdued state so as not to endanger himself or his surroundings". This statement was signed as a true one by 44% of all respondents and 56% of the group of respondents who discontinued psychotropic drugs without consulting a doctor.
About 20% of respondents appear to believe that psychotropic drugs in general are misused for recreational purposes. More specifically, in the case of antidepressants it is 23% of respondents and in the case of antipsychotics 19% of respondents.
Discussion. This work outlines possible relationships in the issue under study, but the relatively small number of respondents and their unrepresentative composition does not allow making absolutely substantiated statements about the situation in Ukraine on the basis of these data. Therefore, the author considers it useful to repeat this survey on a larger number of respondents with a representative composition.
Due to the dissemination method (described in the chapter named "Materials and methods"), the questionnaire was probably completed mainly by people who are significantly more interested in the issue, which may influence the survey results. Another difficulty arising from the way the questionnaire was distributed is the lack of any feedback on how seriously the respondents approached the questionnaire.
Links: 1. https://scielo.isciii.es/scielo.php?script=sci_ arttext&pid=S0213-61632012000400003 2. https://pubmed.ncbi.nlm.nih.gov/1535931/ Conclusion. From the obtained data, it can be concluded that a person's awareness in the field of psychotropic drugs is most influenced by their own experience of their use. For this reason, the author would be interested to know how psychiatric patients are informed by their physicians.
In the case of non-adherence to treatment, the author came to two possible reasons. One of them may be the perception of the use of psychotropic drugs as a manifestation of one's own weakness or inability to independently cope with the routine daily aspects of life. Another likely reason is the lack of mutual understanding and awareness on the part of the attending physician.
Perspectives of further research. Based on the second reason for non-adherence with the patient's treatment, which is insufficient patient awareness or insufficient understanding between the patient and the attending physician, the author would like to specify more clearly and narrow the field of further research.
The author singles out the main area of activity of the analysis of psychiatrists' and psychotherapists' work during the consultation of patients. The main topic will be the study of the availability and depth of information offered to patients by the attending physician. The main purpose of this study will be to evaluate and offer recommendations to both parties to solve the problem and to inform patients better, first of all, about their health situation and the importance of treatment. Undoubtedly, the questions of cancellation or replacement of drugs will also be raised, but under the strict supervision of the attending physician.