What made me feel better? Patients' own explanations for the improvement of their depression.
BACKGROUND
Depression is common among primary care patients and the usual treatment often consists of antidepressant medication and supportive counselling/follow-ups. Previous studies have shown that patients and professionals have different beliefs about treatment, which in turn can decrease acceptance of the diagnosis, compliance and treatment outcome.


OBJECTIVE
The purpose of this study was to investigate previously depressed patients' beliefs about the cause of their improvement.


METHODS
Depressed primary care patients (n = 184) who considered themselves improved at follow-up answered an open-ended question about what they believed had made them better. Among these 117 patients had, in addition to treatment as usual, participated in an intervention with patient education and group counselling (the Contactus programme), whereas 67 were controls. The groups were comparable at baseline and 82% were on antidepressants.


RESULTS
In total, the patients mentioned 14 separate improving factors, which could be organized to the larger themes external factors, self-management, passing spontaneously and professional help. The most frequently mentioned factors for improvement were the Contactus programme (53.0%), antidepressants (40.2%) and personal development (27.2%). Few gender and age differences were seen. The controls who mentioned professional help were more likely to have a better outcome.


CONCLUSIONS
The patients were generally positive to professional help such as antidepressants and the Contactus programme. Patient education and group counselling seems to be a valuable supplement to treatment of depressed patients in primary care.
Division of Psychiatry, Department of Clinical Science, Umeå University, S-90185 Umeå, Sweden. maja.hansson@psychiat.umu.se
Maja
M
Hansson
Jayanti
J
Chotai
Owe
O
Bodlund
D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D003376:Counseling; D003469:Culture; D003863:Depression / Q000188:drug therapy* / Q000523:psychology*; D003866:Depressive Disorder / Q000188:drug therapy / Q000628:therapy; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D011320:Primary Health Care; D012648:Self Care; D057566:Self Report; D016896:Treatment Outcome; D055815:Young Adult
D000928:Antidepressive Agents