The Decision-Making Process of Antidepressant Use Among Patients with Depression: A Grounded Theory Study

Area of Science:

• Psychiatry
• Mental Health Research
• Patient Decision-Making

Background:

• Depression significantly impacts quality of life and treatment adherence.
• Understanding patient perspectives on antidepressant use is crucial for effective care.
• Prior antidepressant use influences current treatment decisions.

Purpose of the Study:

• To explore decision-making processes in patients with depression and prior antidepressant use.
• To develop a theoretical model of antidepressant treatment decision-making from the patient's viewpoint.

Main Methods:

• A constructivist grounded theory approach was employed.
• Semi-structured in-depth interviews were conducted with 26 patients.
• Data analysis involved iterative coding until theoretical saturation.

Main Results:

• The core process identified was "Weighing the Pros and Cons: Navigating Between the Quagmire of Illness and the Hope of Treatment."
• Decision-making involves three stages: decision trigger, active evaluation, and dynamic adaptation.
• Patients balanced medication benefits against concerns like stigma and side effects, with trust and individualized trade-offs shaping choices.

Conclusions:

• Antidepressant decision-making is a dynamic, non-linear process.
• Non-adherence is not always strategic self-management.
• Third-party advice and identity tension influence treatment experiences.