Patients' perspectives on antidepressant treatment in consultations with physicians.
Patient perspectives on antidepressant treatment and physician attention, and responses toward these in consultations with patients diagnosed with depression, are rarely studied. We analyzed video-recorded consultations with general practitioners (GPs) and psychiatrists. We used conversation analysis and systemic functional linguistics and found that the perspectives patients expressed related to the possibility of achieving, and the inability to retain, a sense of agency. Patients also presented indirect expressions of shame and expressions suggesting alienation toward medical treatment. GPs attended to patient perspectives by talking about medication indirectly. When patients expressed their perspectives, GPs responded by being nonauthoritative but also without prompting patients to elaborate on their reflections. Psychiatrists responded authoritatively and never urged patients to reflect on their perspectives. Shared decision making did not take place because physicians did not explore patients' perspectives in depth or offer their expertise by taking these perspectives into consideration.
1University of Copenhagen, Copenhagen, Denmark.
Christina Fogtmann
CF
Fosgerau
Annette Sofie
AS
Davidsen
D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001294:Attitude to Health; D003718:Denmark; D003866:Depressive Disorder / Q000188:drug therapy* / Q000451:nursing* / Q000523:psychology; D005260:Female; D058005:General Practitioners; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011570:Psychiatry; D011578:Psycholinguistics; D012017:Referral and Consultation; D014741:Video Recording
D000928:Antidepressive Agents
communication, medical; conversation analysis; depression; language / linguistics; medication; qualitative analysis