Help Seeking for Depression by Primary Care Patients

Boston University Medical Campus, Boston MA

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Abstract

[unreadable] DESCRIPTION (provided by applicant): Although screening for depression in primary care settings is recommended for all adults, it is known that approximately 50% of depression cases go undetected in primary care. In the absence of systematic screening for depression, it may be necessary for primary care patients to actively seek help for depressive symptoms from their primary care physicians (PCPs). In order to first seek help for depression, patients need to view depression as a serious, disabling condition, and they need to be ready to seek treatment. Through qualitative and quantitative research with primary care patients with depression, we will explore the constructs of the self-regulation model of illness behavior as predictors of help-seeking for depression among patients who have and who have not sought treatment for depression. The specific aim of this study is to provide empirical evidence for a conceptual model of help-seeking for depression that takes account of patients' understanding of their illness and the factors associated with patients' help- seeking for depression from PCPs. The long-term objective of this study is to obtain pilot data for a future R34 application which will test a patient activation intervention to empower patients to seek help for depression from PCPs. Men and women from a primary care clinic who report depression and have either received treatment for depression or who have not received treatment, and who report having a PCP, will be invited to participate in a semi-structured, face-to-face interview to explore their experiences of seeking help for depression from their PCPs. The interview will include verbal questions form standardized assessments of demographic factors, depression and anxiety, patients' beliefs about depression treatment, patients' perceptions of depression, patients' coping behavior and readiness to change, and patients' perceived stigma of depression and other psychological morbidities. These scales will be used to describe and enhance the qualitative data obtained through the face-to-face interviews. Interviews will be transcribed and coded using thematic analysis. Because depression is expected to be the largest burden of disease worldwide, second only to heart disease, by 2020, it is necessary to increase the recognition and treatment of depression in primary care. Determining the factors associated with patients' decisions to seek help for depression from PCPs is a first step in helping patients to take action to improve their mental health. [unreadable] [unreadable] [unreadable]