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Gender differences in hospitalised patients’ perceived reasons for their depression

Published online by Cambridge University Press:  10 July 2013

Brandon A. Gaudiano*
Affiliation:
Warren Alpert Medical School of Brown University and Butler Hospital
Kathryn Nowlan
Affiliation:
University of North Carolina-Chapel Hill
Jessica A. Hughes
Affiliation:
University of Tennessee-Knoxville
Ivan W. Miller
Affiliation:
Warren Alpert Medical School of Brown University and Butler Hospital
*
Correspondence to: Dr Brandon Gaudiano, Butler Hospital, Psychosocial Research Program, 345 Blackstone Boulevard, Providence, Rhode Island 02906, USA. E-mail: Brandon_Gaudiano@brown.edu
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Abstract

Background

Perceived causes of depression can affect treatment preferences and outcomes. Men and women may have somewhat differing views about the causes of their depression, but there is a paucity of research on gender differences in hospitalised patients with depression.

Aims

We examined potential gender differences in hospitalised patients’ perceived causes for their depression and their relationship with treatment beliefs and preferences.

Method

A sample of 52 psychiatric inpatients hospitalised with depression was recruited and completed self-report measures of reasons for depression, depression severity, treatment beliefs and preferences.

Results

Biological reasons for depression were associated with more severe depression and more positive medication beliefs. In addition, results showed that women were significantly more likely to endorse physical and biological reasons for their depression compared with men. Gender moderated the relationship between physical reasons for depression and medication beliefs, such that men endorsing physical reasons found antidepressants less acceptable and had more negative beliefs about medication compared to women.

Conclusions

Findings indicate that depressed men and women in the hospital may have differing views about the causes of their depression and this may affect the acceptability of treatments. Depression treatment in inpatient settings should be better personalised to match the beliefs of individual patients.

Type
Original Research Article
Copyright
Copyright © NAPICU 2013 

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References

Addis, M.E. (2008) Gender and depression in men. Clinical Psychology: Science and Practice. 15(3): 153168.Google Scholar
Addis, M.E., Carpenter, K.M. (1999) Why, why, why? Reason-giving and rumination as predictors of response to activation- and insight-oriented treatment rationales. Journal of Clinical Psychology. 55(7): 88188894.3.0.CO;2-E>CrossRefGoogle ScholarPubMed
Addis, M.E., Jacobson, N.S. (1996) Reasons for depression and the process and outcome of cognitive-behavioral psychotherapies. Journal of Consulting and Clinical Psychology. 64(6): 14171424.CrossRefGoogle ScholarPubMed
Addis, M.E., Truax, P., Jacobson, N.S. (1995) Why do people think they are depressed? The Reasons for Depression Questionnaire. Psychotherapy: Theory, Research and Practice. 32(3): 476483.CrossRefGoogle Scholar
Aikens, J.E., Nease, D.E. Jr., Nau, D.P. Jr., Klinkman, M.S., Schwenk, T.L. (2005) Adherence to maintenance-phase antidepressant medication as a function of patient beliefs about medication. Annals of Family Medicine. 3(1): 2330.CrossRefGoogle ScholarPubMed
Angst, J., Gamma, A., Gastpar, M., Lépine, J.P., Mendlewicz, J., Tylee, A., Depression Research in European Society Study (2002) Gender differences in depression. Epidemiological findings from the European DEPRES I and II studies. European Archives of Psychiatry and Clinical Neuroscience,. 252(5): 201209.CrossRefGoogle ScholarPubMed
Atkinson, D.R., Worthington, R.L., Dana, D.M., Good, G.E. (1991) Etiology beliefs, preferences for counseling orientations, and counseling process and outcome. Journal of Counseling Psychology. 38(3): 1736.CrossRefGoogle Scholar
Bann, C.M., Parker, C.B., Bradwejn, J., Davidson, J.R., Vitiello, B., Gadde, K.M. (2004) Assessing patient beliefs in a clinical trial of Hypericum perforatum in major depression. Depression and Anxiety. 20(3): 114122.CrossRefGoogle Scholar
Beck, A.T., Steer, R.A., Garbin, R.A. (1988) Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clinical Psychology Review. 8(1): 77100.CrossRefGoogle Scholar
Boughton, S., Street, H. (2007) Integrated review of the social and psychological gender differences in depression. Australian Psychologist. 42(3): 187197.CrossRefGoogle Scholar
Bystritsky, A., Wagner, A.W., Russo, J.E., Stein, M.B., Sherbourne, C.D., Craske, M.G., Roy-Byrne, P.P. (2005) Assessment of beliefs about psychotropic medication and psychotherapy: development of a measure for patients with anxiety disorders. General Hospital Psychiatry. 27(5): 313318.CrossRefGoogle ScholarPubMed
Churchill, R., Khaira, M., Gretton, V., Chilvers, C., Dewey, M., Duggan, C., Lee, A., Nottingham Counselling and Antidepressants in Primary Care (CAPC) Study Group (2000) Treating depression in general practice: factors affecting patients’ treatment preferences. British Journal of General Practice. 50(460): 905906.Google ScholarPubMed
Cooper, L.A., Gonzales, J.J., Gallo, J.J., Rost, K.M., Meredith, L.S., Rubenstein, L.V., Wang, N.Y., Ford, D.E. (2003) The acceptability of treatment for depression among African-American, Hispanic, and white primary care patients. Medical Care. 41(4): 479489.CrossRefGoogle ScholarPubMed
DeRubeis, R.J., Hollon, S.D., Amsterdam, J.D., Shelton, R.C., Young, P.R., Salomon, R.M., O'Reardon, J.P., Lovett, M.L., Gladis, M.M., Brown, L.L., Gallop, R. (2005) Cognitive therapy vs medications in the treatment of moderate to severe depression. Archives of General Psychiatry. 62(4): 409416.CrossRefGoogle ScholarPubMed
Dwight-Johnson, M., Sherbourne, C.D., Liao, D., Wells, K.B. (2000) Treatment preferences among depressed primary care patients. Journal of General Internal Medicine. 15(8): 527534.CrossRefGoogle ScholarPubMed
Faul, F., Erdfelder, E., Buchner, A., Lang, A.-G. (2009) Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behavior Research Methods. 41(4): 11491160.CrossRefGoogle ScholarPubMed
Foulks, E.F., Persons, J.B., Merkel, R.L. (1986) The effect of patients’ beliefs about their illnesses on compliance in psychotherapy. American Journal of Psychiatry. 143(3): 340344.Google ScholarPubMed
Gaudiano, B.A., Hughes, J.A., Miller, I.W. (2013) Patients’ treatment expectancies in clinical trials of antidepressants versus psychotherapy for depression: a study using hypothetical vignettes. Comprehensive Psychiatry. 54(1): 2833.CrossRefGoogle ScholarPubMed
Gelhorn, H.L., Sexton, C.C., Classi, P.M. (2011) Patient preferences for treatment of major depressive disorder and the impact on health outcomes: a systematic review. The Primary Care Companion to CNS Disorders. 13(5). doi: 10.4088/PCC.11r01161.Google ScholarPubMed
Horne, R., Weinman, J. (1999) Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. Journal of Psychosomatic Research. 47(6): 555567.CrossRefGoogle ScholarPubMed
Jorm, A.F., Medway, J., Christensen, H., Korten, A.E., Jacomb, P.A., Rodgers, B. (2000) Public beliefs about the helpfulness of interventions for depression: effects on actions taken when experiencing anxiety and depression symptoms. Australian and New Zealand Journal of Psychiatry. 34(4): 619626.CrossRefGoogle ScholarPubMed
Kessler, R.C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K.R., Rush, A.J., Walters, E.E., Wang, P.S. (2003) The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA. 289(23): 30953105.CrossRefGoogle ScholarPubMed
Khalsa, S.R., McCarthy, K.S., Sharpless, B.A., Barrett, M.S., Barber, J.P. (2011) Beliefs about the causes of depression and treatment preferences. Journal of Clinical Psychology. 67(6): 539549.CrossRefGoogle ScholarPubMed
Kilmartin, C. (2005) Depression in men: communication, diagnosis, and therapy. Journal of Men's Health and Gender. 2: 9599.CrossRefGoogle Scholar
Kornstein, S.G., Schatzberg, A.F., Thase, M.E., Yonkers, K.A., McCullough, J.P., Keitner, G.I., Gelenberg, A.J., Ryan, C.E., Hess, A.L., Harrison, W., Davis, S.M., Keller, M.B. (2000) Gender differences in chronic major and double depression. Journal of Affective Disorders. 60(1): 111.CrossRefGoogle ScholarPubMed
Kwan, B.M., Dimidjian, S., Rizvi, S.L. (2010) Treatment preference, engagement, and clinical improvement in pharmacotherapy versus psychotherapy for depression. Behaviour Research and Therapy. 48(8): 799804.CrossRefGoogle ScholarPubMed
Long, Q., Little, R.J., Lin, X. (2008) Causal inference in hybrid intervention trials involving treatment choice. Journal of the American Statistical Association. 103(482): 474484.CrossRefGoogle Scholar
Löwe, B., Schulz, U., Gräfe, K., Wilke, S. (2006) Medical patients’ attitudes toward emotional problems and their treatment. What do they really want? Journal of General Internal Medicine. 21(1): 3945.CrossRefGoogle ScholarPubMed
Prins, M.A., Verhaak, P.F., Bensing, J.M., van der Meer, K. (2008) Health beliefs and perceived need for mental health care of anxiety and depression – the patients’ perspective explored. Clinical Psychology Review. 28(6): 10381058.CrossRefGoogle Scholar
Robbins, P.R., Tanck, R.H. (1991) Gender differences in the attribution of causes for depressed feelings. Psychological Reports. 68: 12091210.CrossRefGoogle ScholarPubMed
Schweizer, S., Peeters, F., Huibers, M., Roelofs, J., van Os, J., Arntz, A. (2010) Does illness attribution affect treatment assignment in depression? Clinical Psychology and Psychotherapy. 17(5): 418426.CrossRefGoogle ScholarPubMed
Shadish, W.R., Clark, M.H., Steiner, P.M. (2008) Can nonrandomized experiments yield accurate answers? A randomized experiment comparing random and nonrandom assignments. Journal of the American Statistical Association. 103(484): 13341344.CrossRefGoogle Scholar
Sidani, S., Miranda, J., Epstein, D.R., Bootzin, R.R., Cousins, J., Moritz, P. (2009) Relationships between personal beliefs and treatment acceptability, and preferences for behavioral treatments. Behaviour Research and Therapy. 47(10): 823829.CrossRefGoogle ScholarPubMed
Srinivasan, J., Cohen, N.L., Parikh, S.V. (2003) Patient attitudes regarding causes of depression: implications for psychoeducation. Canadian Journal of Psychiatry. 48(7): 493495.CrossRefGoogle ScholarPubMed
Steer, R.A., Ball, R., Ranieri, W.F., Beck, A.T. (1999) Dimensions of the Beck Depression Inventory-II in clinically depressed outpatients. Journal of Clinical Psychology. 55(1): 117128.3.0.CO;2-A>CrossRefGoogle ScholarPubMed
Thwaites, R., Dagnan, D., Huey, D., Addis, M.E. (2004) The Reasons for Depression Questionnaire (RFD): UK standardization for clinical and non-clinical populations. Psychology and Psychotherapy: Theory, Research and Practice. 77(3): 363374.CrossRefGoogle ScholarPubMed
van Schaik, D.J.F., Klijn, A.F.J., van Hout, H.P.J, van Marwijk, H.W., Beekman, A.T., de Haan, M., van Dyck, R. (2004) Patients’ preferences in the treatment of depressive disorder in primary care. General Hospital Psychiatry. 26(3): 184189.CrossRefGoogle ScholarPubMed
van Voorhees, B.W., Fogel, J., Houston, T.K., Cooper, L.A., Wang, N.Y., Ford, D.E. (2005) Beliefs and attitudes associated with the intention to not accept the diagnosis of depression among young adults. Annals of Family Medicine. 3(1): 3846.CrossRefGoogle Scholar
Virtanen, M., Honkonen, T., Kivimäki, M., Ahola, K., Vahtera, J., Aromaa, A., Lönnqvist, J. (2007) Work stress, mental health and antidepressant medication findings from the Health 2000 Study. Journal of Affective Disorders. 98(3): 189197.CrossRefGoogle ScholarPubMed
Warren, L. (1983) Male intolerance of depression: a review with implications for psychotherapy. Clinical Psychology Review. 3: 147156.CrossRefGoogle Scholar
Weissman, M.M., Klerman, G.L. (1977) Sex differences and the epidemiology of depression. Archives of General Psychiatry. 34(1): 98111.CrossRefGoogle ScholarPubMed
Whisman, M.A., McClelland, G.H. (2005) Designing, testing, and interpreting interactions and moderator effects in family research. Journal of Family Psychology. 19(1): 111120.CrossRefGoogle ScholarPubMed
Wilhelm, K., Parker, G., Geerlings, L., Wedgwood, L. (2008) Women and depression: a 30 year learning curve. Australian and New Zealand Journal of Psychiatry. 42(1): 312.CrossRefGoogle ScholarPubMed