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Nonmedical factors important in treatment of depression
A treatment plan for depression should include nonmedical
factors based on a patient’s own health beliefs, a new study reports. "Understanding the patient factors associated with good
treatment results would allow clinicians to customize
depression treatments to particular patient profiles -- and
thus minimize relapse or recurrence," said Charlotte Brown, PhD,
f the Western Psychiatric Institute and Clinic at the University
of Pittsburgh School of Medicine, in Pennsylvania, the lead
author of the article appearing in the July/August issue of
General Hospital Psychiatry. Studies of depressed patients tend to focus on individuals who
are seeing psychiatrists; this study is one of a few to focus
on depressed patients seeking treatment in a primary care
setting. Most patients with mental illnesses seek help from
heir primary care physicians, according to the study. Brown and colleagues analyzed the treatment results from a group
of 181 primary care patients who received eight months of
treatment for moderate to severe depression. Patients who perceived more self-control of their health
experienced greater reduction in depression symptoms, whether
they were treated with psychotherapy or the antidepressant
nortriptyline, the researchers found. Indeed, this greater sense of control of health was the most
important factor associated with reduction in depressive
symptoms in patients treated with interpersonal psychotherapy,
the study results suggested. "These findings are consistent with earlier reports suggesting
that a person’s expectations and beliefs are important in the
successful treatment of depression, particularly with
psychotherapy," said Brown. The researchers also noted that patients suffering from a
psychiatric disorder in addition to depression -- such as
panic disorder or generalized anxiety disorder -- were less
likely to recover from their depressive episode, whether they
were treated with psychotherapy or nortriptyline. "These findings highlight the need to adequately assess symptoms
of anxiety disorder and a patient’s beliefs in the control-
lability of depressive symptoms and functioning in order to
treat depression effectively and to minimize the risk of
relapse and recurrence," concludes Brown. This study was supported by the National Institute of Mental
Health and the American Foundation for Suicide Prevention.
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