Patient and Physician Perspectives of Depressive Symptoms and Expectations for Treatment Outcome: Results from a Web-Based Survey

Abstract

Purpose A previous international study suggested that perceptions of depression symptoms, social function, and treatment expectations are different between patients/physicians. We aimed to examine whether such differences exist in Japan. Methods A web-based survey was conducted with patients who reported that they had been diagnosed with depression, and physicians who reported that they had treated patients with depression, in Japan. Questionnaires were designed to quantify patients’ perceptions of symptoms, social function, and treatment expectations. Patients were categorized into three stages of disorder based on their reported current symptoms: severe symptomatic, mild symptomatic, and remission. Physicians were assigned up to three patients, were provided with patient information from the questionnaire completed by those patients, and finally the completed questionnaire forms for each patient. Agreement between the perceptions of the patients and physicians was examined for each stage. Results Of the 2618 eligible patients, 828 were assigned to 326 eligible physicians. Overall, we found small differences in the perceptions of depression treatment between patients/physicians. Slightly fewer physicians than patients reported physical symptoms (85% vs 91%; p=0.018) in the mild symptomatic stage. Fewer physicians than patients reported cognitive symptoms in the severe (82% vs 87%; p=0.029) and mild (54% vs 66%; p=0.003) symptomatic stages. Social function was deemed to be lower by physicians than by patients, across all stages of disorder (p<0.001). Regarding treatment expectations, more physicians than patients reported “return to a normal life” in the mild symptomatic (51% vs 35%, p<0.001) and remission stages (57% vs 36%, p<0.001), and more patients than physicians reported “reduction of side effects” in the severe (10% vs 4%, p=0.004) and mild (12% vs 5%, p<0.001) symptomatic disorder stages. Conclusion These results suggest small differences in patient/physician perceptions of depression treatment in Japan. Discrepancies between patients’/physicians’ perceptions may vary depending on the medical environment.

Emotional blunting in patients with depression. Part IV: differences between patient and physician perceptions

“…Other studies have also shown clinically relevant differences between patient and HCP perceptions in depression [ 17 – 21 ]. This may be of clinical significance, as discordance between patient and physician perceptions has been shown to be associated with poorer treatment outcomes in patients with depression [ 28 ].…”

“…The importance of patient-centered care in managing mental health disorders such as depression is well-recognized [ 11 – 16 ]. However, studies have shown that differences exist between the perspectives of patients with depression and their healthcare providers (HCPs) regarding the importance and impact of symptoms experienced and treatment goals [ 17 – 21 ]. Data on HCP perspectives on the prevalence of emotional blunting and its impact on activities of daily living in patients with depression are lacking.…”

Depressive disorders and their pharmacotherapy in routine clinical practice

“…J. Ishigooka и соавт. [14] по результатам онлайн-опроса пациентов и врачей установили, что когнитивные симптомы депрессии способны распознать только 82% врачей в случае тяжелой депрессии и 54% -при легких формах. Среди врачей 15% не были осведомлены о возможных соматических проявлениях депрессии.…”