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Adolescent Primary Care Patients’ Preferences for Depression Treatment

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Abstract

Despite efficacious treatments for depression in youth, current data indicate low rates of care. To better understand reasons for these low rates of care, we examined treatment preferences for depression treatment. Adolescents (N=444) who screened positive for depression at a primary care visit completed measures of predisposing, enabling, and need characteristics thought to be related to help seeking. Results indicated a strong tendency for adolescents to prefer active treatment (72%) versus watchful waiting (28%), and for youth to prefer counseling (50%) versus medication (22%). Female gender, prior treatment experience, and current depression and anxiety were related to preference for active treatment over watchful waiting. In multivariable analyses, female gender and current anxiety symptoms remained significant predictors of preference for active treatment. Ethnicity, attitudes about depression care, prior treatment experience, and anxiety symptoms were related to preference for medication over counseling. In multivariable analyses, those with negative attitudes about depression treatment generally, with positive attitudes about treatment via medication, or with current anxiety symptoms were more likely to prefer medication. Youth preference for counseling over medication may contribute to low adherence to medication treatment and underscores the importance of patient education aimed at promoting positive expectations for treatments.

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Acknowledgments

We thank Lingqi Tang and Naihua Duan for consultation on statistical analysis. Participating sites include: Kaiser Permanente Los Angeles Medical Center, The Venice Family Clinic, Ventura County Medical Center & Mental Health, Children’s Hospital Pittsburgh & Western Psychiatric Institute, and UCLA Departments of Pediatrics & Psychiatry. We also thank Martin Anderson, Chris Landon, Pamela Murray, Angela Albright, Samantha Fordwood, Emily McGrath, James McKowen, and Diana Polo. Supported by Grant HS09908 (Asarnow) from the AHRQ and P30 MH068639 (Wells) from NIMH.

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Authors and Affiliations

  1. RAND Corporation, Arlington, Virginia, USA

    Lisa H. Jaycox

  2. University of California, Los Angeles, California, USA

    Joan Rosenbaum Asarnow

  3. RAND Corporation, Santa Monica, California, USA

    Cathy D. Sherbourne

  4. University of California, Davis, California, USA

    Margaret M. Rea

  5. Kaiser Permanente, Los Angeles, California, USA

    Anne P. LaBorde

  6. RAND Corporation and University of California, Los Angeles, California, USA

    Kenneth B. Wells

  7. RAND Corporation, 1200 South Hayes Street, Arlington, Virginia, 22202-5050, USA

    Lisa H. Jaycox

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  1. Lisa H. Jaycox
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  2. Joan Rosenbaum Asarnow
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Correspondence to Lisa H. Jaycox.

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Jaycox, L.H., Asarnow, J.R., Sherbourne, C.D. et al. Adolescent Primary Care Patients’ Preferences for Depression Treatment. Adm Policy Ment Health 33, 198–207 (2006). https://doi.org/10.1007/s10488-006-0033-7

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