Patients Who Choose Own Depression Treatment Do Better
Treatment for Depression
Patients who chose their own treatment for depression had better outcomes than patients whose treatment was determined by their physicians alone, a new study of veterans has found.
Researchers at the Department of Veterans Affairs Puget Sound Health Care System in Seattle studied 335 adults who had a clinical diagnosis of depression. The study appears in the October issue of the Annals of Behavioral Medicine.
Participants, overwhelmingly male with an average age of 57, were allowed to choose from a menu of treatment that included medication alone, psychotherapy alone or both. Researchers determined that 72 percent of the patients were receiving treatment that matched their preferences and that these patients showed more rapid improvement in symptoms of depression.
Patients were assessed at one week, three months and nine months in telephone interviews, on functional status; severity of depression; disability (the amount depression interferes with variables such as work, family, social life and activities); and changes in health outcomes and treatment preferences. Most of the patients showed improvement in all of the categories at the three- and nine-month intervals.
"The good news is that depression improved for patients in both groups," says study coauthor Edmund F. Chaney. "The positive impact of treatment was more noticeable in the early stages of treatment. Although we can't say for certain, it might be that the preference-matched patients were better able to stick with the treatment plan in the early stages."
The study also showed that the 15 percent of patients who preferred medication alone were older and more likely to be white and married than the 24 percent who preferred psychotherapy alone or the 60 percent who preferred both. African-American patients were less likely than white patients to find either treatment acceptable and Hispanic patients were less likely to find medication acceptable. A vast majority of the patients indicated a preference for some type of active treatment.
Approximately 18.8 million American adults, or about 9.5 percent of the U.S. population age 18 and olderhave a depressive disorder in a given year,, according to the National Institute of Mental Health.
Patients in the VA system are usually assigned treatment based on their previous treatment history, contraindications to psychotropic medication and other barriers such as cost of medication, distance to psychotherapist, and time constraints.