When patients with depression actively engage in decision making they are less likely to withdraw from treatment prematurely and more likely to adhere to medication, receive treatment according to practice guidelines and show improvements in clinical outcomes. A study of 94 people with depression in Ottawa, Canada looked into their decision making. 67 of them were uncertain about their treatment decision. Common decisions identified were whether or not to take medications, attend support groups or receive electro-convulsive therapy (ECT) and the location of treatment. 40 patients who had made a decision about their treatment in the recent past were uncertain about it. The 'uncertain' group felt less informed, less supported and less clear about how they valued the benefits and risks of options. Other influential factors included concerns about confidentiality, distress from depression, embarrassment, panic attacks and lack of energy. However, few patients wanted to hand over decision making to their family or their doctor. To support decision making participants identified the need for: discussions with their psychiatrist, nurse or doctor; access to printed information; and information provided by health professionals and health societies.
Stacey, D. ... [et al] - Decision-making needs of patients with depression: a descriptive study Journal of Psychiatric and Mental Health Nursing May 2008, 15(4), 287-295