Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
J Behav Ther Exp Psychiatry. 2014 Mar;45(1):170-7. doi: 10.1016/j.jbtep.2013.10.003. Epub 2013 Oct 15.
Preferences and attitudes patients hold towards treatment are important, as these can influence treatment outcome. In depression research, the influence of patients' preference/attitudes on outcome and dropout has mainly been studied for antidepressant medication, and less for psychological treatments. We investigated the effects of patients' preference and attitudes towards psychological treatment and antidepressant medication on treatment outcome and dropout, and tested specificity of effects.
Data are based on a randomized trial testing the effectiveness of behavioural activation (BA) vs antidepressant medication (ADM) for major depression (MDD) in Iran. Patients with MDD (N = 100) were randomized to BA (N = 50) or ADM (N = 50). Patients' preference/attitudes towards psychotherapy and ADM were assessed at baseline and associated with dropout and treatment outcome using logistic regression and multilevel analysis.
High scores on psychotherapy preference/attitude and low scores on ADM preference/attitude predicted dropout from ADM, while no association between dropout and preference/attitude was found in BA. Psychotherapy preference/attitude moderated the differential effect of BA and ADM on one outcome measure, but the association disappeared after one year.
Because in Iran most patients have only access to ADM, offering a psychological treatment for depression could attract especially those patients that prefer this newly available treatment.
Patients' preferences and attitudes towards depression treatments influence dropout from ADM, and moderate the short-term difference in effectiveness between BA and ADM. The fact that dropout from BA was not affected by preference/attitude speaks for its acceptability among patients.
患者对治疗的偏好和态度很重要，因为这些因素会影响治疗结果。在抑郁症研究中，患者对治疗的偏好/态度对治疗结果和脱落的影响主要针对抗抑郁药物进行了研究，而针对心理治疗的研究则较少。我们研究了患者对心理治疗和抗抑郁药物的偏好和态度对治疗结果和脱落的影响，并检验了效果的特异性。
数据基于一项在伊朗进行的随机试验，该试验测试了行为激活（BA）与抗抑郁药物（ADM）治疗重度抑郁症（MDD）的有效性。100 名 MDD 患者被随机分配至 BA 组（N=50）或 ADM 组（N=50）。在基线时评估患者对心理治疗和 ADM 的偏好/态度，并使用逻辑回归和多层次分析将其与脱落和治疗结果相关联。
对心理治疗的偏好/态度得分高、对 ADM 的偏好/态度得分低，预示着会从 ADM 中脱落，而在 BA 中未发现脱落与偏好/态度之间存在关联。心理治疗偏好/态度调节了 BA 和 ADM 对一项结果测量的差异效应，但这种关联在一年后消失。
由于在伊朗，大多数患者只能获得 ADM，因此提供抑郁症的心理治疗可能会吸引那些更倾向于这种新的治疗方法的患者。
患者对抑郁症治疗的偏好和态度会影响 ADM 的脱落，并且会调节 BA 和 ADM 之间短期有效性的差异。BA 脱落不受偏好/态度影响的事实表明患者对其的接受程度。
