NZ Survey…

SURVEY – VIEWS AND EXPERIENCES OF ANTIDEPRESSANTS

(Please note: This survey will be placed on Survey Monkey)

1. GENERAL INFORMATION
    Gender ____________ Age __________________
    Ethnicity ______________________
    Sexual Orientation __________________
    Religion ________________________
    Annual Personal Income (approximate) ______________________
    Occupation _________________________
    Level of Education (please check one):
    Did not complete high school ____
    Completed High School ____
    Diploma/Certificate after high school ____
    University Undergraduate Degree ____
    University Postgraduate Degree ____
2. THE PRESCRIBING PROCESS
    In what year were you first prescribed anti-depressant medication? ________________
    What is the name of your anti-depressant (if you know) ______________________
    Who first suggested the idea of taking antidepressants? (please circle one)
      Myself Relative Friend GP Psychiatrist Other (please say who)________
    Who prescribed it ? (please circle one) GP Psychiatrist Other
    What problem(s) did you think the anti-depressants were being prescribed for?
    ______________________________________________________________________________
    Did the prescribing doctor say what problem(s) s/he thought you had that would be helped by taking anti-depressants? YES NO
    If ‘Yes’ what did s/he say?
    ______________________________________________________________________________
    In the two weeks before first being prescribed anti-depressants which, if any, of the following did you experience:
    (Participants will be provided with boxes to tick)
      (1) depressed mood most of the day, nearly every day
      (2) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
      (3) significant weight loss when not dieting, or weight gain (e.g., a change of more than 5% of body weight in a month)
      (4) insomnia or hypersomnia (sleeping too much) nearly every day
      (5) psychomotor agitation (e.g. unintentional and purposeless motions, including pacing around a room, wringing one’s hands) or retardation (e.g. slowing down of thoughts and reduction of physical movements) nearly every day
      (6) fatigue or loss of energy nearly every day
      (7) feelings of worthlessness or excessive or inappropriate guilt
      (8) diminished ability to think or concentrate, or indecisiveness, nearly every day
      (9) recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
    Please describe any other experiences or problems that you were having, that are not described above, which led to you being prescribed antidepressants.
    ______________________________________________________________________________
    In the two months before being prescribed anti-depressants did you experience a significant loss (eg. the death of a loved one, relationship break-up, loss of your job etc.) YES / NO
    If YES, please briefly state the nature of your loss:
    ______________________________________________________________________________
    Were you told what positive effects you could expect from taking the anti-depressants? Yes / No
    If ‘Yes’ what positive effects were you told about?
    ______________________________________________________________________________
    Did the prescribing doctor tell you how anti-depressants work? Yes / No
    If yes, can you give a brief summary of what you were told?
    ______________________________________________________________________________
    Did the prescribing doctor tell you how long you should take the anti-depressants for? YES NO
    If ‘Yes’…
      about a month ___
      1 – 3 months ___
      4 – 6 months ___
      7 – 12 months ___
      more than a year ___
      the rest of your life ___
      until you felt better ___
    How would you describe your relationship with the doctor?
      very satisfactory …. satisfactory …. not sure …. not satisfactory …. not at all satisfactory
    How well do you think s/he understood your problem(s)?
      A lot …. Quite a lot…. OK …. Not a lot …. Not at all
    About how long did the doctor spend with you on the day s/he prescribed anti-depressants?
      0 – 10 minutes ___
      11 – 20 minutes ___
      21 – 30 minutes ___
      31 – 40 minutes ___
      41 – 50 minutes ___
      51 – 60 minutes ___
      more than an hour ___
    How well did the doctor inform you about possible side effects?
      Very well Quite well A little Not at all
    What possible side effects did the doctor tell you about?
    ____________________________________________________________________________
3. YOUR EXPERIENCE OF ANTIDEPRESSANTS
    Did you take the anti-depressant? (please circle one) Yes No
    If ‘No’ please state briefly why not
    _____________________________________________________________________________
    If ‘Yes’ for how long did you take the anti-depressant? ________________________
    Are you still taking them? Yes No
    If ‘No’ please say why not, by ticking one or more of the options below
      I felt better so no longer needed them ___
      I finished the amount prescribed to me ___
      They didn’t work ___
      They had unpleasant side-effects ___
      Other (please state what)
      ____________________________________________
    Overall, I have found anti-depressants: (Please circle one)
      Very Helpful … Helpful …Had no effect … Harmful… Very Harmful
    While taking anti-depressants I felt:
      Much less depressed … A bit less depressed… The same ….. A bit more depressed… Much more depressed…
    If your anti-depressant reduced your depression, how quickly did that happen
      same day… next day… 2–7 days … 2nd week … 3rd week … 4th week … next month
    While taking anti-depressants my quality of life was:
      Greatly improved … Slightly improved…. Unchanged… Slightly worse … A lot worse
    Please rate your level of depression for the following three time periods from
      1 = not at all depressed to 10 = the most depressed I can imagine being
      The year before taking anti-depressants ____
      While taking anti-depressants ____
      Since stopping anti-depressants ____ (leave blank if you are still taking them)
    Which, if any, of the following side effects do you think you experienced as a result of taking the anti-depressants ?
    Please rate as: 0 – not at all, 1 – mild, 2 – moderate, 3 – severe
      Nausea _____
      Diarrhea _____
      Agitation _____
      Headaches _____
      Loss of sex drive _____
      Erection difficulties _____
      Failure to reach orgasm _____
      Suicidality _____
      Dry mouth _____
      Drowsiness _____
      Dizziness _____
      Weight gain _____
      Weight loss _____
      Tremors _____
      Feeling not like myself _____
      Emotional numbing _____
      Reduction in
      positive feelings _____
      Feeling aggressive or violent _____
      Caring less about others _____
      Addiction to the anti-depressants _____
      Withdrawal effects after stopping taking the anti-depressants _____
      Other (please state)
      ______________________________________________________ _____
      Other (please state)
      ______________________________________________________ _____
    Which, if any, of the following benefits did you experience as a result of your use of antidepressants?
      Calmer ___
      Better mood ___
      Happier ___
      Enjoyed self more ____
      More active ____
      Slept better ___
      Ate better ____
      More energy ___
      Less anxiety ____
      Less fear ____
      Felt healthier ____
      More confident ____
      Better concentration ____
      Able to work better ____
      Got on better with others ____
      Less headaches ___
      Less physical discomfort ____
    As the final question in this section, could you please complete this sentence or paragraph.
    In my life, antidepressants have been …
    ___________________________________________________________