Depressed patients' perceptions of depression treatment decision-making

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).

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.

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.

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.

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.