MIDAS Project Publication Abstracts
Posternak, M.A., Zimmerman, M. How accurate are
patients in reporting their antidepressant treatment history? Journal
of Affective Disorders, 2003, 75, 115-124.
Background: A patient's report of his/her antidepressant
treatment history is one of the most important pieces of information
used in selecting an antidepressant regimen. It is currently unknown
how accurate patients are in describing and characterizing their
antidepressant treatment history.
Methods: Seventy-three patients receiving treatment for
depression at our outpatient psychiatric practice were interviewed
by an independent evaluator who was blind to each patient's treatment
history. Information was obtained regarding which antidepressant
and augmentation regimens patients had undergone, antidepressant
doses, duration of trials, and the nature of response to each trial.
The results of these interviews were then compared with patients'
actual treatment history as elicited from an independent chart review.
Results: Patients recalled 85 of the 104 (81.7%) monotherapy
trials they had undergone in the past 5 years, but only recalled
12 of 46 (26.1%) augmentation trials (p<.001). Patients were
found to be very reliable in distinguishing between those trials
that were of adequate dose and duration and those that were not.
Patients were also generally reliable in depicting the quality of
response to past trials, though patient report of a past negative
trial was significantly more reliable than a report of a past positive
trial. The presence of current depressive symptomatology did not
adversely affect patients' ability to recall past trials or accurately
describe their responses to past regimens.
Limitations: All patients were treated by a single psychiatrist,
and all trials occurred within the last 5 years.
Conclusion: Patients are able to recall the majority of
monotherapy trials they have undergone, but have great difficulty
remembering when two medications were taken concurrently, i.e.,
augmentation trials. Patient report appears to be a satisfactory
method for obtaining information regarding trial adequacy and response
in most, but not all instances.
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