Depressed patients' perceptions of depression treatment decision-making.

OBJECTIVE: Little is known about the feasibility and effects of patient-clinician shared decision-making (SDM) for depression treatment. Within a goal of informing the design of a SDM intervention, the objective of this study was to investigate depressed patients' perceptions of the treatment decision-making process with general practitioners (GPs). SETTING AND PARTICIPANTS: Data were gathered from a convenience sample of 40 depressed patients to understand key aspects of treatment decision-making from the patient perspective. The sample varied in depression severity and type of setting in which treatment was sought. MAIN VARIABLES STUDIED: Semi-structured interview questions focused on patients' prior experiences with depression and treatment, perceptions of the treatment decision-making process, and needs and expectations about treatment. Current depression severity was also assessed.
RESULTS: Patient lack of insight regarding depression severity substantially delayed patient engagement in treatment seeking and decision-making. Patients expected their GPs to be a first and main source of objective information and discussion about depression and treatment and to provide emotional support for decision-making. Patients also identified needs for additional information about depression and its treatment, as well as concerns about certain aspects of treatment.
CONCLUSIONS: The depression treatment context has some aspects that differ from treatment decision-making for other types of health conditions. SDM approaches for depression treatment should be adapted based on depression severity and patient-identified needs.