Examining the Impact of Patient-Reported Hope for Improvement and Patient Satisfaction with Clinician/Treatment on the Outcome of Major Depressive Disorder Treatment.
OBJECTIVE
This analysis aims at examining if patient-reported variables such as hope for improvement and patient satisfaction with clinician/treatment could influence the outcome major depressive disorder (MDD) treatment, namely depression remission, in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial.


METHODS
Retrospective cohort study.


METHODS
The STAR*D study was conducted at 18 primary care and 23 psychiatric care settings in the United States from 2001-2007 and was funded by the National Institute of Mental health (NIMH). The analysis contained in this manuscript was conceptualized at the Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences and performed at the UCLA School of Public Health.


METHODS
Using data from STAR*D, the current study used logistic regression and survival analyses to examine the relationship between depressive symptoms remission and two sets of self-reported factors: Hope for improvement and, Patient satisfaction with treatment/clinician.


RESULTS
First, more than 90% of STAR*D patients reported having high hope for improvement (agree or strongly agree) and more than 66% endorsed high satisfaction with clinicians and more than 50% expressed high satisfaction with treatments (very or mostly satisfied). Second, hope for improvement was predictive of depression remission (p<0.05). Third, satisfaction with clinician/treatment, did not predict remission.


CONCLUSIONS
This study shows the impact that patients' subjective hope for improvement can have on predicting depression remission in contrast to satisfaction with clinician/treatment. Future studies should prospectively incorporate patients' subjective attitudes regarding hope for improvement and satisfaction with clinicians and treatments as mediators and moderators of MDD treatment success.
Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center Los Angeles, California 90048, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Waguih William
WW
IsHak
Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia, USA.
Jennice
J
Vilhauer
School of Public Health, University of California Los Angeles, Los Angeles, California, USA.
Richard
R
Kwock
School of Public Health, University of California Los Angeles, Los Angeles, California, USA.
Fan
F
Wu
University of California Davis Law School, Davis, California, USA.
Sherif
S
Gohar
Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center Los Angeles, California 90048, USA.
Katherine
K
Collison
Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center Los Angeles, California 90048, USA.
Shannon Nicole
SN
Thomas
Western University of Health Sciences, College of Osteopathic Medicine, Pomona, California, USA.
Lancer
L
Naghdechi
School of Public Health, University of California Los Angeles, Los Angeles, California, USA.
David
D
Elashoff
Major depressive disorder; hope; patient satisfaction; remission