title: Do patients׳ illness beliefs predict depression measures at six months in primary care; a longitudinal study.
abstract: BACKGROUND
  Depressive disorders are prevalent and costly but there is a lack of evidence on how best to select treatments for mild to moderate depression in primary care. Illness beliefs have been shown to affect the outcome from physical illness, but there is limited information on the beliefs of patients who are depressed.
  
  
  OBJECTIVE
  To measure patients׳ beliefs about depression at baseline and determine whether these relate to depression severity at six months.
  
  
  METHODS
  Primary care patients with a recently diagnosed episode of depression completed the Beliefs about Depression Questionnaire and depression severity scores at baseline. The primary outcome was the change in depression severity score on the Hospital Anxiety and Depression Scale after six months.
  
  
  RESULTS
  227/292 (78%) participants completed follow-up questionnaires. Initial severity of depression at baseline, and particular beliefs about the causes, consequences and timeline of depression predicted poorer outcomes, whereas a belief in using exercise or keeping busy to treat depression predicted improved outcomes. Prescription of antidepressants did not appear to mediate these relationships.
  
  
  CONCLUSIONS
  This was an initial study using a new validated questionnaire and it cannot be predicted whether these results are representative or would be reproduced in other populations. Although participants were primary care patients whose GP (General Practitioner) had coded as having a new incident episode of depression in the preceding six months, 43% of participants stated they had been depressed for more than a year. Sufficient participants were recruited to ensure the study was adequately powered but participation rate was 30%, raising the possibility of response bias.
  
  
  CONCLUSIONS
  Illness beliefs may help to predict outcomes in depression and therefore assessing and addressing patients׳ beliefs about their depression may enhance treatment.
authors.affiliation: Southern Health NHS Foundation Trust, Becton Centre, Barton-on-Sea, Hampshire BH25 7AE, United Kingdom. Electronic address: Jeannette.lynch1@southernhealth.nhs.uk.
authors.forename: Jeannette
authors.initials: J
authors.lastname: Lynch
authors.affiliation: Primary Care & Population Sciences, University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST, United Kingdom.
authors.forename: Michael
authors.initials: M
authors.lastname: Moore
authors.affiliation: Health Psychology Section, Psychology Dept., Institute of Psychiatry, KCL, 5th floor, Bermondsey Wing, Guy׳s Hospital Campus, London Bridge, London SE1 9RT, United Kingdom.
authors.forename: Rona
authors.initials: R
authors.lastname: Moss-Morris
authors.affiliation: Primary Care & Population Sciences, University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST, United Kingdom.
authors.forename: Tony
authors.initials: T
authors.lastname: Kendrick
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D001007:Anxiety; D003863:Depression / Q000175:diagnosis* / Q000188:drug therapy; D003866:Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy; D004739:England; D005260:Female; D006801:Humans; D007600:Judgment; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011320:Primary Health Care; D011340:Problem Solving; D020377:Self Efficacy; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013850:Thinking; D013997:Time Factors
chemical_list: D000928:Antidepressive Agents
keywords: Depression; Illness beliefs; Longitudinal study; Primary care