Medical Patients' Attitudes Toward Emotional Problems and Their Treatment
What Do They Really Want?
Version of Record online: 15 NOV 2005
Journal of General Internal Medicine
Volume 21, Issue 1, pages 39–45, January 2006
How to Cite
Löwe, B., Schulz, U., Gräfe, K. and Wilke, S. (2006), Medical Patients' Attitudes Toward Emotional Problems and Their Treatment. Journal of General Internal Medicine, 21: 39–45. doi: 10.1111/j.1525-1497.2005.0266.x
- Issue online: 5 JAN 2006
- Version of Record online: 15 NOV 2005
- Manuscript received August 20, 2004 Initial editorial decision October 26, 2004 Final acceptance August 23, 2005
- patient preferences;
- primary care
Background: Understanding medical patients' attitudes toward emotional problems and their management is crucial to overcoming obstacles to efficient depression treatment.
Objective: To investigate attitudes toward emotional problems, psychotherapy, antidepressants, alternative treatment approaches, and self-management techniques in depressed and nondepressed medical outpatients.
Design: Cross-sectional interview study, including quantitative and qualitative methods.
Patients: Eighty-seven depressed subjects (mean age, 41.0 years; 66% female) and 91 nondepressed subjects (mean age, 41.4 years; 67% female) from 7 internal medicine outpatient clinics and 12 family practices (participation rate, 91%).
Measurements: Depression diagnoses were established using a structured diagnostic interview, and patient attitudes were investigated with open-ended interview questions regarding treatment preferences, factors improving and impairing emotional well-being, and patients' self-management to improve well-being.
Results: Among the depressed patients, psychotherapy was the most frequently preferred treatment (29%) and the most common factor reported to improve emotional well-being (36%). Twenty-two percent of the depressed patients desired depression treatment within their current medical system, but requested substantially more time to communicate with their physician. Antidepressants were rarely mentioned as a preferred treatment (6%) or factor improving well-being (11%). Thirty-eight percent of the depressed patients attributed their impaired mood to health problems. Compared with the depressed patients, the nondepressed controls preferred significantly less frequent depression-specific therapies.
Conclusions: The vast majority of medical outpatients prefer treatment approaches for emotional problems that go beyond antidepressant medication therapy. Health care providers should consider providing sufficient time to communicate with their patients, the strong preference for psychotherapy, and an appropriate treatment of comorbid physical conditions.