Depression Treatment Should Consider Patients' Health Beliefs

Article excerpt

Treatment for depression should include factors based on, a patient's own health beliefs, a new study has reported.

"Understanding the patient factors associated with good treatment results would allow clinicians to customize depression treatments to particular patient profiles-and thus minimize relapse or recurrence," said Charlotte Brown, Ph.D., of the Western Psychiatric Institute and Clinic at the University of Pittsburgh School of Medicine. Her study appeared in the July-August 2000 issue of General Hospital Psychiatry.

Studies of depressed patients tend to focus on individuals who are seeing psychiatrists; this study focuses on depressed patients seeking treatment in a primary care setting. Most patients with mental illnesses seek help from their primary care physicians, according to the study.

Dr. Brown analyzed the treatment results from a group of 181 primary care patients who received eight months of treatment for moderate to severe depression.

Patients-who perceived more self-control of their health experienced greater reduction in depression symptoms whether they were treated with psychotherapy or the antidepressant nortriptyline, the researchers found.

The study results suggested that this greater sense of control of health was the most important factor associated with reduction in depressive symptoms in patients treated with interpersonal psychotherapy.

"These findings are consistent with earlier reports suggesting that a person's expectations and beliefs are important in the successful treatment of depression, particularly with psychotherapy," said Dr. Brown.

The researchers also noted that patients suffering from a psychiatric disorder in addition to depression-such as panic disorder or generalized anxiety disorder-were less likely to recover from their depressive episode whether they were treated with psychotherapy or nortriptyline.

"These findings highlight the need to adequately assess symptoms of anxiety disorder and a patient's beliefs in the controllability of depressive symptoms and functioning in order to treat depression effectively and to minimize the risk of relapse and recurrence," concludes Dr. …