Treatment preferences in patients with first episode depression

• Published in: Journal of affective disorders 2013-05, Vol.147 (1), p.94-100
• Main Authors: Houle, Janie, Villaggi, Benjamin, Beaulieu, Marie-Dominique, Lespérance, François, Rondeau, Gilles, Lambert, Jean
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Antidepressants; Antidepressive Agents - therapeutic use; Biological and medical sciences; Cross-Sectional Studies; Depression; Depression - psychology; Depression - therapy; Depressive Disorder - psychology; Depressive Disorder - therapy; Family histories; Female; First time; Humans; Illness representations; Male; Medical sciences; Middle Aged; Mood disorders; Neuropharmacology; Patient Preference; Pharmacology. Drug treatments; Preferences; Psychiatry; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychopharmacology; Psychotherapy; Treatment preferences; Young Adult
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2012.10.016

Abstract Background Treatment preferences of patients suffering from depression may affect adherence and clinical outcomes. This study examines associations between patients’ treatment preferences, their characteristics and illness representations of depression. Methods Illness representations of depression (IPQ-R), treatment acceptability and preferences were assessed in 88 newly diagnosed patients with first episode depression. Other measures recorded: gender, age, education level, income, psychiatric comorbidity, depressive symptomatology (PHQ-9), a family history of depression, and current treatment of depression. Multiple logistic regression was used to identify factors associated with a preference for psychotherapy. Results Psychotherapy was preferred by 41% of participants, while 31% favored antidepressants. Acceptability was strongly associated with preference. Patients preferring psychotherapy perceived that their depression has more serious consequences than those preferring medication and were more likely to attribute their depression to social causes than psychological or physical causes. Participants who preferred psychotherapy were more likely to be female, have a university degree and have a family history of depression. Limitations The cross-sectional design precludes causal interpretations. Conclusions Preferences vary according to gender, level of education, family history and illness representations. It may be important to provide accurate information on both treatments and discuss patients’ preferences before prescribing treatment.