title: Patients׳ perspectives on how treatment can impede their recovery from depression.
abstract: BACKGROUND
  More than 50% of all major depressive disorder (MDD) patients experience insufficient improvement from the available treatment options. There is emerging evidence that patients׳ beliefs and experiences about MDD treatment influence treatment outcomes. The aim was to explore patients׳ perspectives on impeding characteristics of professional treatment for the recovery of MDD.
  
  
  METHODS
  In-depth interviews in a purposive sample with 27 recovered MDD patients who had received professional treatment. Data were qualitatively analyzed using constant comparison.
  
  
  RESULTS
  Participants׳ accounts yielded four major impeding themes: lack of clarity and consensus about the nature of the participants׳ MDD and the content of their treatment; precarious relationship with the clinician; unavailability of mental health care; and insufficient involvement of significant others.
  
  
  CONCLUSIONS
  The external generalizability may be limited due to missed other subgroups within depression.
  
  
  CONCLUSIONS
  This study identified a comprehensive overview of impeding characteristics in MDD treatment from patients׳ perspectives. This may help clinicians to understand how patients experience MDD treatment, and to incorporate patients׳ perspectives about treatment into their joint decision-making. This can lead towards increased treatment adherence, motivation and finally success.
authors: Department of Psychiatry, Program for Mood Disorders, Academic Medical Center, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands. Electronic address: r.a.vangrieken@amc.uva.nl.
authors: Rosa A
authors: RA
authors: van Grieken
authors: Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors: Erik J A J
authors: EJ
authors: Beune
authors: Department of Psychiatry, Program for Mood Disorders, Academic Medical Center, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands.
authors: Anneloes C E
authors: AC
authors: Kirkenier
authors: Department of Psychiatry, Program for Mood Disorders, Academic Medical Center, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands.
authors: Maarten W J
authors: MW
authors: Koeter
authors: Department of General Practice/Medical Ethics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors: Myra C B
authors: MC
authors: van Zwieten
authors: Department of Psychiatry, Program for Mood Disorders, Academic Medical Center, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands; Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands.
authors: Aart H
authors: AH
authors: Schene
mesh_terms: D000328:Adult; D003657:Decision Making; D003865:Major Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
keywords: Communication in health care; Major depressive disorder; Patients׳ perspective; Professional treatment; Qualitative research; Recovery