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Treatment preferences among depressed primary care patients

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Abstract

OBJECTIVE: To understand patient factors that may affect the probability of receiving appropriate depression treatment, we examined treatment preferences and their predictors among depressed primary care patients.

DESIGN: Patient questionnaires and interviews.

SETTING: Forty-six primary care clinics in 7 geographic regions of the United States.

PARTICIPANTS: One thousand one hundred eighty-seven English-and Spanish-speaking primary care patients with current depressive symptoms.

MEASUREMENTS AND MAIN RESULTS: Depressive symptoms and diagnoses were determined by the Composite International Diagnostic Interview (CIDI) and the Center for Epidemiological Studies Depression Scale (CES-D). Treatment preferences and characteristics were assessed using a self-administered questionnaire and a telephone interview. Nine hundred eight-one (83%) patients desired treatment for depression. Those who preferred treatment were wealthier (odds ratio [OR], 3.7; 95% confidence interval [95% CI], 1.8 to 7.9; P=.001) and had greater knowledge about antidepressant medication (OR, 2.6; 95% CI, 1.6 to 4.4; P≤.001) than those who did not want treatment. A majority (67%, n=660) of those preferring treatment preferred counseling, with African Americans (OR, 2.2; 95% CI, 1.0 to 4.8, P=.04 compared to whites) and those with greater knowledge about counseling (OR, 2.1; 95% CI, 1.6 to 2.7, P≤.001) more likely to choose counseling. Three hundred twelve (47%) of the 660 desiring counseling preferred group over individual counseling. Depression severity was only a predictor of preference among those already in treatment.

CONCLUSIONS: Despite low rates of treatment for depression, most depressed primary care patients desire treatment, especially counseling. Preferences for depression treatment vary by ethnicity, gender, income, and knowledge about treatments.

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Correspondence to Megan Dwight-Johnson MD, MPH.

Additional information

Salary support for Dr. Dwight-Johnson from NIMH grant K 12 MH00990-01-01, Partners in Care study funded by Agency for Health Care Policy and Research grant HS08349-02.

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Dwight-Johnson, M., Sherbourne, C.D., Liao, D. et al. Treatment preferences among depressed primary care patients. J GEN INTERN MED 15, 527–534 (2000). https://doi.org/10.1046/j.1525-1497.2000.08035.x

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  • DOI: https://doi.org/10.1046/j.1525-1497.2000.08035.x

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