title: Optimism and pessimism as predictors of initiating and ending an antidepressant medication treatment.
abstract: BACKGROUND
  The personality variables optimism and pessimism are potential risk factors for disorders commonly treated with antidepressants.
  
  
  OBJECTIVE
  To evaluate optimism and pessimism as predictors of initiating and ending an antidepressant treatment.
  
  
  METHODS
  Data consisted of 29,930 public sector employees with no record of diagnosed depression. Optimism and pessimism were measured using the Revised Life Orientation Test (LOT-R) at baseline. The data of purchases of antidepressants were from the national Drug Prescription Register.
  
  
  RESULTS
  During the mean follow-up of 4.4 years, 1681 participants initiated and of them 1288 ended an antidepressant treatment lasting at least 100 days. In the adjusted model, high optimism was associated with a lower likelihood of starting antidepressant medication treatment (hazard ratios, HR, 0.67, 95% CI 0.62-0.73) and a higher likelihood of stopping the treatment (HR = 1.18, 95% CI 1.08-1.30). High pessimism was associated with a higher likelihood of starting antidepressant medication treatment (HR = 1.27, 95% CI 1.16-1.38) and a lower likelihood of stopping it (HR = 0.89, 95% CI 0.80-0.98). These associations remained after optimism score was adjusted for pessimism and vice versa or those with symptoms of mental health problems at baseline were removed from the analyses.
  
  
  CONCLUSIONS
  Low optimism and high pessimism are independently associated with an increased likelihood of initiating antidepressant medication treatment, but with a decreased likelihood of ending it during the follow-up.
authors.affiliation: Researcher, Department of Psychiatry, University of Turku , Turku , Finland.
authors.forename: Kim
authors.initials: K
authors.lastname: Kronström
authors.forename: Hasse
authors.initials: H
authors.lastname: Karlsson
authors.forename: Hermann
authors.initials: H
authors.lastname: Nabi
authors.forename: Tuula
authors.initials: T
authors.lastname: Oksanen
authors.forename: Paula
authors.initials: P
authors.lastname: Salo
authors.forename: Noora
authors.initials: N
authors.lastname: Sjösten
authors.forename: Marianna
authors.initials: M
authors.lastname: Virtanen
authors.forename: Jaana
authors.initials: J
authors.lastname: Pentti
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
authors.forename: Jussi
authors.initials: J
authors.lastname: Vahtera
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001294:Attitude to Health; D003866:Depressive Disorder / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D017150:Public Sector; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016312:Treatment Refusal / Q000523:psychology*; D000078329:Workforce
chemical_list: D000928:Antidepressive Agents