Long-term antidepressant use: patient perspectives of benefits and adverse effects

Long-term antidepressant treatment has increased and there is evidence of adverse effects; however, little is known about patients’ experiences and views of this form of treatment.This study used mixed methods to examine patients’ views and experiences of long-term antidepressant treatment, including benefits and concerns. Data from 180 patients, who were long-term users of antidepressants (3–15 years), were extracted from an anonymous online survey of patients’ experiences of antidepressants in New Zealand. Participants had completed rating scales about the effectiveness of antidepressants, levels of depression before and during antidepressant use, quality of life, and perceived adverse effects. Two open-ended questions allowed participants to comment on personal experiences. The majority (89.4%) reported that antidepressants had improved their depression although 30% reported moderate-to-severe depression on antidepressants. Common adverse effects included withdrawal effects (73.5%), sexual problems (71.8%), and weight gain (65.3%). Adverse emotional effects, such as feeling emotionally numb (64.5%) and addicted (43%), were also common. While the majority of patients were pleased with the benefits of antidepressant treatment, many were concerned about these adverse effects. Some expressed a need for more information about long-term risks and increased information and support to discontinue.

Looking behaviour and preference for artworks: The role of emotional valence and location

The position of an item influences its evaluation, with research consistently finding that items occupying central locations are preferred and have a higher subjective value. The current study investigated whether this centre-stage effect (CSE) is a result of bottom-up gaze allocation to the central item, and whether it is affected by item valence. Participants (n=50) were presented with three images of artistic paintings in a row and asked to choose the image they preferred. Eye movements were recorded for a subset of participants (n=22). On each trial the three artworks were either similar but different, or were identical and with positive valence, or were identical and with negative valence. The results showed a centre-stage effect, with artworks in the centre of the row preferred, but only when they were identical and of positive valence. Significantly greater gaze allocation to the central and left artwork was not mirrored by equivalent increases in preference choices. Regression analyses showed that when the artworks were positive and identical the participants’ last fixation predicted preference for the central art-work, whereas the fixation duration predicted preference if the images were different. Overall the result showed that item valence, rather than level of gaze allocation, influences the CSE, which is incompatible with the bottom-up gaze explanation. We propose that the centre stage heuristic, which specifies that the best items are in the middle, is able to explain these findings and the centre-stage effect.