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Conceptual Models of Treatment in Depressed Hispanic Patients

Department of Family Medicine, Albert Einstein College of Medicine, Bronx, NY

CORRESPONDING AUTHOR: Alison Karasz, PhD, Department of Family Medicine, Albert Einstein College of Medicine, 3544 Jerome Avenue, Bronx, NY 10467, akkarasz{at}montefiore.org

PURPOSE Though patient variables are likely to play an important role in the undertreatment of depression, little is known of patients’ perceptions of standard depression treatments. In an effort to understand their perspective, we investigated depressed Hispanic patients’ perceptions of primary care treatments and the specific benefits associated with them.

METHODS We undertook semistructured interviews with 121 depressed Hispanic medical patients waiting for their appointments. We developed and implemented a coding scheme using standard iterative procedures.

RESULTS More than one half of the patients viewed physician consultation and medication as helpful. Almost all patients considered psychotherapy to be helpful. Supportive talk was the most commonly mentioned specific benefit of physician consultation. The most common benefit of medication was its anxiolytic, sedative effect; energizing effects were less common. The most common benefits associated with psychotherapy included support, advice, and catharsis. Patients currently taking medication for depression had a more favorable view of pharmacological treatment; differences by language of interview were noted.

CONCLUSIONS Patients’ perceptions of the specific efficacies of depression treatment did not match priorities implicit in current treatment guidelines. Such perceptions may play a key role in shaping patients’ decisions to initiate and maintain treatment.

Key Words: Ethnic groups • mental health • depression • antidepressants • psychotherapy • physician-patient relations • conceptual models • primary care

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