NYAPRS Note: More research could be helpful in demonstrating conclusively something that most consumers of psychiatric services already know well; a bonded relationship with a prescriber—particularly one that demonstrates cultural valuation, horizontal power dynamics, and attenuation to preferences—contributes to better quality of life and responsiveness to medication.
Quality of Relationship to Doctor Significantly Improves Antidepressant Efficacy
Mad in America; 1/24/2015
The more that patients feel that they have a high-quality relationship with their prescribing physician, the more likely that they will regard their own responses to antidepressants as positive, according to a study in Acta Psychiatrica Scandinavica. The team of Australian and UK researchers also identified a host of other social factors that seem to improve antidepressant response.
The researchers used an online questionnaire which had 47 questions about the prescribing process, pre-existing beliefs about antidepressant effectiveness, side effects, beliefs about the causes of depression, and other topics. The 1,781 respondents whose surveys were analyzed had been prescribed an antidepressant within the past 5 years.
The researchers found that “the quality of the relationship with the prescriber was related to both depression reduction and improved (quality of life).” In addition, they found reduction in feelings of depression were related to younger age, higher income, and being fully informed about the pros and cons of the medications by the prescriber.
People who responded well to antidepressants also typically had fewer beliefs that depression was caused by social circumstances and were more likely to believe that antidepressant benefits were related to “chemical rather than placebo effects.”
“There are multiple non-pharmacological processes involved in recovery while taking (antidepressants),” the researchers concluded. “Enhancing them, for example focusing on the prescriber-patient relationship and giving more information, may enhance recovery rates, with or without (antidepressants).”
Read, J at al. Understanding the non-pharmacological correlates of self-reported efficacy of antidepressants. Acta Psychiatrica Scandinavica. Published early online January 9, 2015. DOI: 10.1111/acps.12390. (Abstract)