Clinical and sociodemographic associations with treatment selection in major depression
| Autor: | Anne M. Stiggelbout, Ingrid V. E. Carlier, Frans G. Zitman, Sumayah Rodenburg-Vandenbussche, I. M. Van Vliet, A.M. van Hemert |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Mental Health Services medicine.medical_specialty Referral major Drug Prescriptions Outcome monitoring 03 medical and health sciences Depressive disorder major Sex Factors 0302 clinical medicine Internal medicine Outcome Assessment Health Care Outpatients medicine Humans Outcome assessment (health care) 030212 general & internal medicine Patient preference Medical prescription Selection (genetic algorithm) Depression (differential diagnoses) Retrospective Studies Primary Health Care business.industry Depressive disorder Middle Aged Combined Modality Therapy Antidepressive Agents Multinomial logistic regression analysis 030227 psychiatry Psychotherapy Psychiatry and Mental health Antidepressant Female business Treatment choices Clinical decision-making |
| Zdroj: | General Hospital Psychiatry, 54, 18-24 |
| DOI: | 10.1016/j.genhosppsych.2018.06.004 |
| Popis: | Objective To investigate treatment selection in a naturalistic sample of MDD outpatients and the factors influencing treatment selection in specialized psychiatric care. Method Multinomial Logistic Regression analysis investigated associations between treatment selection and patients' sociodemographic and clinical characteristics, using retrospective chart review data and Routine Outcome Monitoring (ROM) data of MDD outpatients. Results Of the patients included for analyses (N = 263), 34% received psychotherapy, 32% received an antidepressant (AD) and 35% received a combination. Men were more likely than women to receive AD with reference to psychotherapy (ORAD = 5.57, 95% CI 2.38–13.00). Patients with severe depression and patients with AD use upon referral, prescribed by their general practitioner, were more likely to receive AD (ORsevere depression = 5.34, 95% CI 1.70–16.78/ORAD GP = 9.26, 95% CI 2.53–33.90) or combined treatment (ORsevere depression = 6.32, 95% CI 1.86–21.49/ORAD GP = 22.36, 95% CI 5.89–83.59) with respect to psychotherapy. More severe patients with AD upon referral received combined treatment less often compared to psychotherapy (OR = 0.14, 95% CI 0.03–0.68). Conclusion AD prescriptions in primary care, severity and gender influenced treatment selection for depressive disorders in secondary psychiatric care. Other factors such as the accessibility of treatment and patient preferences may have played a role in treatment selection in this setting and need further investigation. |
| Databáze: | OpenAIRE |
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