title: Depression beliefs, treatment preference, and outcomes in a randomized trial for major depressive disorder.
abstract: Previous studies suggest that individual preferences for medication- or psychotherapy-based treatments for depression may affect outcomes in clinical trials that compare these two forms of treatment. We assessed patients' beliefs about the causes of their depression, their preferred treatment, and strength of that preference in 80 patients participating in a 12-week clinical trial evaluating neuroimaging predictors of response to cognitive behavior therapy (CBT) or escitalopram. Forty-five patients expressed a preference for one of the 2 treatments, but being matched to preference did not influence remission or completion rates. Medication-preferring patients were more likely to terminate the trial early, regardless of treatment received. CBT-preferring patients rarely endorsed unknown causes for their depression, and medication-preferring patients were highly unlikely to identify pessimistic attitudes as a source of their depression. Among patients willing to be randomized to treatment, preference does not appear to strongly influence outcome. Specific preferences for CBT or medication may reflect differing conceptualizations about depressive illness, knowledge of which may enhance treatment retention and efficacy.
authors: Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1256 Briarcliff Road NE, Building A, 3rd Floor, Atlanta, GA 30306, USA. bdunlop@emory.edu
authors: Boadie W
authors: BW
authors: Dunlop
authors: Mary E
authors: ME
authors: Kelley
authors: Tanja C
authors: TC
authors: Mletzko
authors: Cristina M
authors: CM
authors: Velasquez
authors: W Edward
authors: WE
authors: Craighead
authors: Helen S
authors: HS
authors: Mayberg
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003469:Culture; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004311:Double-Blind Method; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging / Q000379:methods; D010043:Outcome and Process Assessment, Health Care; D010352:Patient Dropouts / Q000523:psychology; D057240:Patient Preference / Q000523:psychology*; D012074:Remission Induction / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents