Medical patients' attitudes toward emotional problems and their treatment. What do they really want?
BACKGROUND
Understanding medical patients' attitudes toward emotional problems and their management is crucial to overcoming obstacles to efficient depression treatment.


OBJECTIVE
To investigate attitudes toward emotional problems, psychotherapy, antidepressants, alternative treatment approaches, and self-management techniques in depressed and nondepressed medical outpatients.


METHODS
Cross-sectional interview study, including quantitative and qualitative methods.


METHODS
Eighty-seven depressed subjects (mean age, 41.0 years; 66% female) and 91 nondepressed subjects (mean age, 41.4 years; 67% female) from 7 internal medicine outpatient clinics and 12 family practices (participation rate, 91%).


METHODS
Depression diagnoses were established using a structured diagnostic interview, and patient attitudes were investigated with open-ended interview questions regarding treatment preferences, factors improving and impairing emotional well-being, and patients' self-management to improve well-being.


RESULTS
Among the depressed patients, psychotherapy was the most frequently preferred treatment (29%) and the most common factor reported to improve emotional well-being (36%). Twenty-two percent of the depressed patients desired depression treatment within their current medical system, but requested substantially more time to communicate with their physician. Antidepressants were rarely mentioned as a preferred treatment (6%) or factor improving well-being (11%). Thirty-eight percent of the depressed patients attributed their impaired mood to health problems. Compared with the depressed patients, the nondepressed controls preferred significantly less frequent depression-specific therapies.


CONCLUSIONS
The vast majority of medical outpatients prefer treatment approaches for emotional problems that go beyond antidepressant medication therapy. Health care providers should consider providing sufficient time to communicate with their patients, the strong preference for psychotherapy, and an appropriate treatment of comorbid physical conditions.
Löwe
Bernd
B
Department of Psychosomatic and General Internal Medicine, University of Heidelberg Medical Center, Heidelberg, Germany. bernd.loewe@med.uni-heidelberg.de
Schulz
Ute
U
Gräfe
Kerstin
K
Wilke
Stefanie
S
D000328:Adult; D000339:Affect; D000553:Ambulatory Care; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D007388:Internal Medicine; D007407:Interviews as Topic; D008297:Male; D017060:Patient Satisfaction; D011613:Psychotherapy; D036301:Qualitative Research; D012648:Self Care; D011795:Surveys and Questionnaires
D000928:Antidepressive Agents