A Secondary Analysis of the Relationships between Depression, Severity, Social and Amotivational Factors, and Decision-making Difficulties
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Date
2011-06
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The Ohio State University
Abstract
The purpose of the secondary analysis is to better understand specific needs by describing relationships between depression severity, decision-making difficulties, and specific sources of decision-making difficulty (social and amotivational), so that improvements can be made in shared decision-making. A secondary cross-sectional analysis was conducted of data from a larger study to describe depressed primary care patient needs and preferences related to decision-making about depression treatment options. The subjects were depressed primary care patients (N=112) enrolled in a large Midwestern HMO, recruited from a larger random-selection case-control study of patients with and without migraine headaches. This analysis focuses on 43% (N=48; “Deciders”) of the sample that was currently making a depression treatment decision. Depression severity was measured using the Center for Epidemiologic Studies Depression (CESD) scale. Specific decision-making difficulties and factors contributing to decision-making difficulties were self-reported as present or absent using a standardized interview protocol. Decision stage was measured with a previously validated single item to assess extent of decision implementation. The results demonstrated that there are statistically significant relationships between some social and amotivational symptoms of depression and decision-making difficulty. Shared decision-making interventions that address the social and amotivational symptoms of depression could improve the treatment decisions of the depressed medical population. This analysis will add to knowledge about specific patient needs for support related to depression treatment decision-making.
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Keywords
decision making, depression, severity, amotivational, social factors, shared decision-making