The results of this study indicate that a significant proportion of parents have a negative opinion on psychotropic medication, and their beliefs differ from general findings regarding their safety.
Deeper socio-cultural beliefs seem to affect the acceptance (or non-acceptance) of medication. In the study of Schnittker [17
], it was shown that African-Americans are more reluctant to take or to accept psychotropic medication for their children in comparison to the Caucasian population. In a recent study [18
] it was shown that Caucasian race is associated with higher proportions of medication use among children in the Child Welfare System. African-American and Latino races were associated with lower proportions of medication use. Our sample was homogeneous regarding race and ethnicity (Greek) and the opinions on psychotropic medication are not statistically differentiated with parental age. The only significant difference found between men and women concerned the question of whether they believe that there are different categories of psychotropic medication. Women seemed to be better informed than men about this issue. Educational level only influenced the fear of drug addiction. Where the educational level was higher, parents seem to be closer to the scientific point of view and they did not fear the risk of addiction as much.
Our results show that most parents have a greater fear concerning their children taking psychotropic medication than for other types of medication. This is consistent with the study of Pappaport and Chubinsky [19
], who found that while parents easily give cough medicine or antibiotics, they are afraid to give medication that might alter the behaviour or thinking of their children. Parental hesitation to administer psychotropic medication to their children may intervene with the treatment and affect treatment compliance. The high percentage of children that discontinue pharmacotherapy confirms that assertion [20
According to our results parents seem to be aware of the distinction of psychoagents into four categories, but the majority of the respondents seem to not be well informed about the safety of psychotropic drugs. This contradiction is probably due to the fact that the structure of the question, concerning the distinction of psychoagents, led to the correct answer. Most of them are afraid of potential dependency, and are affected by anti-drug public opinion. The prevalence of the belief that antipsychotics (69%) and antidepressants (74%) cause addiction is considerable. The use of psychostimulants during childhood in order to treat ADHD (attention deficit hyperactivity disorder) had been accused of causing dependence and predisposition to the use of controlled substances. More recent research has shown that their use does not increase the possibility of substance abuse later in life [21
]. In fact, another study has found that children with ADHD who received pharmacotherapy (methylphenidate) were less likely to use alcohol or substances later in their life, in comparison to children that presented with hyperactivity but did not receive pharmaceutical treatment [23
Most parents consider psychotherapy as the most effective treatment for mental disorders, including childhood schizophrenia (65%). According to Pappaport and Chubinsky [19
], parents accept pharmacotherapy only when behavioural and psychological interventions have been exhausted. They then experience a process of grief and the acceptance of pharmacotherapy seems to coincide with the acceptance of the psychiatric diagnosis. It is the final proof of what they fear. They realize that their child is suffering from a serious mental illness that might accompany them into adulthood.
A considerable proportion of respondents believe that there is overuse of psychotropic medication during childhood. In a study [24
] involving 302 parents whose children were hyperactive, the erroneous opinions about the disorders and the methods of treatment became apparent. A total of 75% of the parents expressed the view that sugar and diet affected hyperactivity, 55% were reluctant for their children to use medication and 33% believed that there is an overuse of drugs in children with hyperactivity disorder.
Even though antipsychotics today occupy a significant place in child psychiatry [25
], there is a recorded reluctance by the mothers to accept them as a treatment option during their child's first psychotic episode [26
]. Reluctance in accepting pharmacotherapy is also presented by fathers of hyperactive boys [27
]. Through identification mechanisms, they consider that treatment with methylphenidate separates their children from their peers and makes them different and isolated.
A high percentage of American parents (57%) accept pharmacotherapy when their child has expressed suicidal ideas and a smaller percentage in the case of disruptive behaviour (34,2%) or hyperactivity (29.5%). These differences are not dependent on socio-economic factors or educational level but on the trust in the doctor [14
]. Hyperactivity and hallucinations/delusions are the main problems for teachers that could lead to the use of pharmaceutical treatment [28
]. In our sample, there was no correlation between the parental attitudes and the severity of the child's problem.
In the United States, in a study involving 1387 subjects [29
], it was found that psychotropic medication represents an effective treatment and less than half of the sample involved were concerned about safety. However, the majority did not want to use them. Several studies [30
] point out that parents are not satisfied by the way in which information is given to them by doctors about the benefits and risks of pharmacotherapy. They wish to know all potential side effects of the medication, and do not appreciate the doctor's withholding information on the subject.