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Treatment of depression improves adherence to interferon beta-1b therapy for multiple sclerosis
D C Mohr1, D E Goodkin, W Likosky
1University of California, San Francisco, USA.
Objectives:
To examine the relationship between patient-reported depression and adherence to therapy with interferon beta-1b (IFN beta-1b) and to test the hypothesis that treatment of depression is associated with improved adherence.
Design:
Patients with multiple sclerosis were followed up 6 months after initiating therapy with IFN beta-1b.
Setting:
A university outpatient multiple sclerosis center, an academic group practice, and a health maintenance organization.
Patients:
Eighty-five patients with clinically evident multiple sclerosis taking IFN beta-1b.
Main Outcome Measure:
Follow-up questionnaire.
Results:
Thirty-five (41%) of the 85 patients reported new or increased depression within 6 months of initiating therapy with IFN beta-1b. Patients experiencing symptoms of depression were more likely to discontinue therapy. Among the patients reporting new or increased depression, 86% who received psychotherapy or antidepressant medication and 38% of the patients who received no therapy for depression continued the IFN beta-1b therapy (P = .003). Although psychotherapy was used as a treatment option more frequently in university and academic group practice-based multiple sclerosis clinics than in the health maintenance organization (P = .02), the treatment adherence patterns were similar across sites.
Conclusions:
These findings support previous findings that patients report increased depression after initiating therapy with IFN beta-1b. Although the source of this depression is unclear, these findings suggest that treating patient-reported depression increases adherence to treatment.