Depressive disorders are prevalent and costly but there is a lack of evidence on how best to select treatments for mild to moderate depression in primary care. Illness beliefs have been shown to affect the outcome from physical illness, but there is limited information on the beliefs of patients who are depressed. It is not known whether beliefs influence outcome from depression and whether this is mediated through medication adherence. The Beliefs about Depression questionnaire (BDQ), based on Leventhal common sense model (CSM) of illness beliefs, was developed from existing qualitative and quantitative data. An initial 76 Item questionnaire was tested on 334 primary care patients with diagnosis of depression and principal component analysis was used to reduce the number of items. The shortened questionnaire (sBDQ) was tested for construct and criterion validity by comparison with existing measures. Test- retest reliability was carried out at two weeks and internal consistency of subscales calculated. A six month longitudinal study was carried out on a cohort of primary care patients with a new episode of depression in the previous six months. Baseline measures were completed and 224 (76%) completed follow-up questionnaires at six months. The primary outcome was the change in depression scores measured by the Hospital and Anxiety Scale - depression subscale (HAD-D). Secondary outcomes were measures of anxiety, functioning, use of medication and use of services. These latter two outcomes were measured both by participant self-report and information from the GP computer systems. Results show that beliefs at baseline contributed to the prediction of depression severity at six months measured by HAD-D or PHQ-9. Severity scores at six months were increased by initial severity but decreased in participants who believed that exercise or activity could control their depression (self-efficacy behaviour). Beliefs about medication did not influence outcome of depression but did predict medication usage. The meaning and possible implications of these findings are discussed in relation to existing literature. Faculty of Medicine Primary Care and Population Sciences Doctor of Philosophy Are patient beliefs important in determining adherence to treatment and outcome for depression? Development and testing of a brief questionnaire to measure beliefs about depression in primary care Dr Jeannette Lynch
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:580535 |
| Date | January 2011 |
| Creators | Lynch, Jeannette |
| Publisher | University of Southampton |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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