Conceptual Models of Treatment in Depressed Hispanic Patients

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 investi-gated depressed Hispanic patients ’ perceptions of primary care treatments and the specifi c benefi ts 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 help-ful. Supportive talk was the most commonly mentioned specifi c benefi t of physi-cian consultation. The most common benefi t of medication was its anxiolytic, sedative effect; energizing effects were less common. The most common benefi ts associated with psychotherapy included support, advice, and catharsis. Patients currently taking medication for depression had a more favorable view of phar-macological treatment; differences by language of interview were noted. CONCLUSIONS Patients ’ perceptions of the specifi c effi cacies 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. Ann Fam Med 2006,4:527-533. DOI: 10.1370/afm.579