Knowledge of and attitudes towards depression and adherence to treatment: The Antidepressant Adherence Scale (AAS)

Adel Gabriel, Claudio Violato

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Background: Non-adherence to treatment can result from forgetting, carelessness, stopping the drug when feeling worse, or stopping the drug when feeling better. Objective: To develop and psychometrically assess a brief instrument that can be easily used in clinical practice to measure adherence to antidepressants. Method: We developed the Antidepressants Adherence Scale (AAS); a self report rating scale including four items to assess the degree to which forgetting, carelessness, and stopping due to feeling worse or feeling better interfere with adherence in the last 4 weeks. Our proposed four-item adherence instrument was developed based on previous research and theory. Participants: Experts in mood disorders (n = 12) participated in the formal validity assessment of the instrument, and the developed instrument was administered to patients who were prescribed antidepressants (n = 63). All patients also completed a multiple choice question instrument to measure knowledge of depression, and a Likert self report questionnaire to assess attitudes towards depression and its treatment. Results: There was 90% agreement among experts that the items were highly relevant providing strong evidence for content validity. Also, there was empirical evidence for validity. There were significant correlations (p < 0.05) between knowledge and attitude subscales and adherence items. The internal consistency reliability (Cronbach's alpha) was 0.66 for the instrument Conclusion and significance: Knowledge of and attitudes to depression and its treatment may have significant impact on the adherence to antidepressants. The AAS can be used in clinical settings (2-3 min to administer) to evaluate patients' adherence to antidepressants.

Original languageEnglish (US)
Pages (from-to)388-394
Number of pages7
JournalJournal of Affective Disorders
Issue number3
StatePublished - Nov 2010

Bibliographical note

Funding Information:
This research project was supported by a research grant from University of Calgary.


  • Antidepressants
  • Depression
  • Knowledge and attitudes
  • Measuring adherence


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