Article

Adolescent primary care patients' preferences for depression treatment

RAND Corporation, Arlington, Virginia 22202-5050, USA.
Administration and Policy in Mental Health and Mental Health Services Research (Impact Factor: 3.44). 04/2006; 33(2):198-207. DOI: 10.1007/s10488-006-0033-7
Source: PubMed

ABSTRACT Despite efficacious treatments for depression in youth, current data indicate low rates of care. To better understand reasons for these low rates of care, we examined treatment preferences for depression treatment. Adolescents (N=444) who screened positive for depression at a primary care visit completed measures of predisposing, enabling, and need characteristics thought to be related to help seeking. Results indicated a strong tendency for adolescents to prefer active treatment (72%) versus watchful waiting (28%), and for youth to prefer counseling (50%) versus medication (22%). Female gender, prior treatment experience, and current depression and anxiety were related to preference for active treatment over watchful waiting. In multivariable analyses, female gender and current anxiety symptoms remained significant predictors of preference for active treatment. Ethnicity, attitudes about depression care, prior treatment experience, and anxiety symptoms were related to preference for medication over counseling. In multivariable analyses, those with negative attitudes about depression treatment generally, with positive attitudes about treatment via medication, or with current anxiety symptoms were more likely to prefer medication. Youth preference for counseling over medication may contribute to low adherence to medication treatment and underscores the importance of patient education aimed at promoting positive expectations for treatments.

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    • "Consumers are more likely to seek and adhere to acceptable treatments (e.g., Bannon & McKay, 2005; Chavira, Stein, Bailey, & Stein, 2003; Kazdin, 2000), resulting in fewer dropouts and greater symptom reduction (e.g., Reimers, Wacker, Cooper, & DeRaad, 1992a). Further, providing consumers with a choice of depression treatments appears to improve outcomes (e.g., Asarnow et al., 2005; Lin et al., 2005). Given ethnic disparities in unmet needs for mental health services and the underrepresentation of Hispanics in treatment studies , it is important to examine whether the acceptability of depression treatments differs by ethnicity. "
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    • "Some prior research suggests that African Americans are less likely to agree with the prescription of psychiatric medication (Schnittker 2003). The impact of such attitudes can be seen in an effectiveness trial for the treatment of adolescent depression in primary care, where African American youths were significantly more likely than other participants to prefer counseling to medication ( Jaycox et al. 2006). "
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