The Weekly Mind Reader: Depression Treatment Priorities

In depression treatment research, there is often a strong emphasis on reducing symptoms. However, patients often hope for something different.

For example, in a survey of more than 2,000 patients taking an antidepressant, nearly twice as many patients indicated that their primary treatment goal was to improve function versus mood. In another survey of more than 6,000 members of the Depression and Bipolar Alliance, patients endorsed managing symptoms and not being controlled by symptoms above all other priorities. Yet, in a study comparing the themes arising from focus groups of patients and providers, professionals put the emphasis on changes in scores on symptom severity scales.

A new The Journal of Clinical Psychiatry analysis explored this disconnect between what patients with depression value most and what researchers prioritize. The study showed that when patients perceived a treatment intervention as being beneficial, they were more likely to achieve a positive outcome in multiple areas, not just symptom reduction. This suggests that patients’ perception of the overall benefit of a treatment intervention is an important factor in determining treatment success. 

Furthermore, the study found that higher functioning, well-being, positive mental health, and the ability to cope with stress should not be considered secondary endpoints. These outcomes are just as important as improvement in symptoms, the researchers said.

The authors recommend broadening the definition of success in depression treatment studies. Studies should take into account patients’ values and expectations. “With a more patient-centered approach, we can improve outcomes and ensure that patients are receiving the care that they need,” they wrote. 

IN OTHER PSYCHIATRY AND NEUROLOGY NEWS THIS WEEK

• The ACTTION systematic review looked at how randomized trials of psychedelics underutilize blind assessment, active drug controls, and testing psychological support against minimal-support conditions. Adding these elements that would improve quality or provide important information, the authors of the paper argue. 
• Acute, complete, and bilateral ischemia of the hippocampus is a rare cause of anterograde amnesia. In this case study, opioids have emerged as a possible cause. 
• Study finds that l-methylfolate (LMF) is effective as an adjunctive treatment in major depressive disorder. It may especially benefit patients with higher BMI and inflammation.
• Using bright yellow smiley face emojis in a text might actually be a telltale sign of depression. 
• The case for long-acting injectables as first-line treatment in early-stage schizophrenia. 
• “My son the doctor” pretty much sums up this week’s Tweet of the Week. 

My parents were very excited about me being the first doctor in the family 😂#blackdoctors #blackmeninmedicine #MedTwitter #firstgeninmedicine pic.twitter.com/bZOqBaXFOe

— Ryan Boyland (@RyanBoyland) May 6, 2023

NEW AT CME INSTITUTE

Click to earn free accredited CME credit.