title: Helpful Factors in the Treatment of Depression from the Patient's, Carer's and Professional's Perspective: A Concept Map Study.
abstract: OBJECTIVE
  Depression research has resulted in knowledge about neurobiology, pharmacological strategies and short-term cost-effective treatments. However, more than two-thirds of all depressed patients experience insufficient improvement. Therefore, a better understanding of what patients, carers and professionals perceive as most helpful in the treatment of depression is needed.
  
  
  METHODS
  Concept mapping, a mixed-method design, was used to identify the patients (n = 33), carers (n = 22) and professionals (n = 50) perspectives. In six brainstorm sessions, the patients, carers and professionals generated 795 ideas, which were condensed into 55 unique statements. Subsequently, 100 participants prioritized and sorted these statements, which were analysed by multidimensional scaling and cluster analysis and visualized as a two-dimensional map.
  
  
  RESULTS
  The 55 statements were clustered in 10 factors and further grouped into four main-factors (meta-clusters): 'Professional therapist', 'Treatment content', 'Structured treatment process' and 'Treatment organisation'. Patients and carers prioritized 'Treatment organisation' higher than professionals, but overall there was considerable agreement about the factors of treatment the participants perceived as most helpful including factors related to the therapeutic relationship and the 'creation of hope'.
  
  
  CONCLUSIONS
  Our study identified factors of depression treatment perceived as helpful according to patients, carers and professionals. Findings suggest that in a scientific era with emphasis on biological psychiatry, not only patients and carers, but also professionals consider aspecific factors the most helpful. Further studies might show that factors we found to be helpful in the treatment for depression, can be generalized to mental health treatment in general.
authors.affiliation: Department of Psychiatry, Program for Mood Disorders, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Rosa A
authors.initials: RA
authors.lastname: van Grieken
authors.affiliation: Department of Psychiatry, Program for Mood Disorders, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Hanka F
authors.initials: HF
authors.lastname: Verburg
authors.affiliation: Department of Psychiatry, Program for Mood Disorders, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Maarten W J
authors.initials: MW
authors.lastname: Koeter
authors.affiliation: Department of Psychiatry, Program for Mood Disorders, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Jessica
authors.initials: J
authors.lastname: Stricker
authors.affiliation: Department of Research and Quality, Arkin Mental Health Care Services, Amsterdam, The Netherlands.
authors.forename: Udo W
authors.initials: UW
authors.lastname: Nabitz
authors.affiliation: Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands.|Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, the Netherlands.
authors.forename: Aart H
authors.initials: AH
authors.lastname: Schene
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D017028:Caregivers / Q000523:psychology*; D016000:Cluster Analysis; D003863:Depression / Q000523:psychology / Q000628:therapy*; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology*; D055815:Young Adult