Treatment preferences among depressed primary care patients.
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.


METHODS
Patient questionnaires and interviews.


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


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


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.
Department of Psychiatry, University of Southern California, Los Angeles, Calif, USA. mdwight@ucla.edu
M
M
Dwight-Johnson
C D
CD
Sherbourne
D
D
Liao
K B
KB
Wells
D000293:Adolescent; D000328:Adult; D003863:Depression / Q000145:classification / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D011320:Primary Health Care; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires