Are treatment preferences relevant in response to serotonergic antidepressants and cognitive-behavioral therapy in depressed primary care patients? Results from a randomized controlled trial including a patients' choice arm

Mergl, Roland; Henkel, Verena; Allgaier, Antje-Kathrin; Kramer, Dietmar; Hautzinger, Martin; Kohnen, Ralf; Coyne, James; Hegerl, Ulrich

doi:10.1159/000318772

Cited by 127Psychotherapy Techniques and ApplicationsTreatment of Major DepressionMental Health Treatment and Access

Are treatment preferences relevant in response to serotonergic antidepressants and cognitive-behavioral therapy in depressed primary care patients? Results from a randomized controlled trial including a patients' choice arm

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Mergl, Roland, Henkel, Verena, Allgaier, Antje-Kathrin, Kramer, Dietmar, Hautzinger, Martin, Kohnen, Ralf, Coyne, James, Hegerl, Ulrich·2011·Psychotherapy and Psychosomatics

DOI 10.1159/000318772

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Abstract

BACKGROUND: Little is known about the influence of depressed patients' preferences and expectations about treatments upon treatment outcome. We investigated whether better clinical outcome in depressed primary care patients is associated with receiving their preferred treatment. METHODS: Within a randomized placebo-controlled single-centre 10-week trial with 5 arms (sertraline; placebo; cognitive-behavioral group therapy, CBT-G; moderated self-help group control; treatment with sertraline or CBT-G according to patients' choice), outcomes for 145 primary care patients with mild-to-moderate depressive disorders according to DSM-IV criteria were investigated. Preference for medication versus psychotherapy was assessed at screening using a single item. Post-baseline difference scores for the Hamilton Depression Rating Scale (HAMD-17) were used to assess treatment outcome (mixed-model repeated-measures regression analysis). RESULTS: Depressed patients receiving their preferred treatment (n = 63), whether sertraline or CBT-G, responded significantly better than those who did not receive their preferred therapy (n = 54; p = 0.001). The difference in outcome between both groups was 8.0 points on the HAMD-17 for psychotherapy and 2.9 points on the HAMD-17 for treatment with antidepressants. Results were not explained by differences in depression severity or dropout rates. CONCLUSIONS: Patients' relative preference for medication versus psychotherapy should be considered when offering a treatment because receiving the preferred treatment conveys an additional and clinically relevant benefit (HAMD-17: +2.9 points for drugs; +8.0 points for CBT-G) in outcome.

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Other studies have shown that accommodating patient treatment can influence treatment outcomes.
“Other studies have shown that accommodating patient treatment can influence treatment outcomes (Adamson et al., 2008; Mergl et al., 2011; Williams et al., 2016).”
From Effects of patient-driven iCBT for anxiety in routine primary care and the relation between increased experience of empowerment and outcome: A randomized controlled trial (2021) · cites this paper as Mergl et al., 2011

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P01-71 - Are Treatment Preferences Relevant for Response to Serotonergic Antidepressants and Cognitive-behavioural Therapy in Depressed Primary Care Patients?
Mergl, R., Henkel, V., Allgaier, A., Kramer, D., Hautzinger, M., Kohnen, R., Coyne, J. C., & Hegerl, U. (2010) · European Psychiatry · doi:10.1016/s0924-9338(10)70290-x
Self-citation
Are treatment preferences relevant for response to serotonergic antidepressants and cognitive-behavioural therapy in depressed primary care patients? Results from a randomized controlled trial including a patient choice arm
Mergl, R., Henkel, V., Allgaier, A., Hautzinger, M., Kohnen, R., Coyne, J. C., & Hegerl, U. (2009) · Pharmacopsychiatry · doi:10.1055/s-0029-1240172
Self-citation
to Serotonergic Antidepressants and Cognitive- Behavioral Therapy in Depressed Primary Care Patients? Results from a Randomized Controlled Trial Including a Patients ’ Choice Arm
Psychosom, P., Mergl, R., Henkel, V., Allgaier, A.-K., Kramer, D., & Words, K. (2015)
Self-citation
Patients' preferences in the treatment of depressive disorder in primary care
van Schaik, D. J. F., Klijn, A. F. J., van Hout, H. P. J., van Marwijk, H. W. J., Beekman, A. T. F., de Haan, M., & van Dyck, R. (2004) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2003.12.001 · Cited by 428 · see citing works
Antidepressant therapy in primary care: Does patient preference affect response?
Taylor, S. M. (2019) · Carolina Digital Repository (University of North Carolina at Chapel Hill) · doi:10.17615/2jfy-tk70

Authors: Mergl, R., Henkel, V., Allgaier, A.-K., Kramer, D., Hautzinger, M., Kohnen, R., Coyne, J., & Hegerl, U.
Affiliations: Leipzig University (DE)
Ludwig-Maximilians-Universität München (DE)
University of Tübingen (DE)
University of Pennsylvania Health System (US)
ORCID: Mergl, Roland
Allgaier, Antje-Kathrin
Kramer, Dietmar
Hautzinger, Martin
Hegerl, Ulrich
Venue: Psychotherapy and Psychosomatics
Publisher: S. Karger AG
Published: 2010-10-23
Volume: 80
Issue: 1
Pages: 39-47
ISSN: 0033-3190 (ISSN-L)
1423-0348
DOI: 10.1159/000318772
OpenAlex: W1966837287
Cited by: 126
References: 27
Citations by year: 2026: 3 · 2025: 4 · 2024: 1 · 2023: 5 · 2022: 2 · 2021: 10 · 2020: 8 · 2019: 9 · 2018: 12 · 2017: 7 · 2016: 6 · 2015: 16 · 2014: 9 · 2013: 10 · 2012: 16
FWCI: 11.98
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.karger.com/Services/SiteLicenses (vor)
www.karger.com/Services/SiteLicenses (tdm)
Locations: Psychotherapy and Psychosomatics (publishedVersion)
PubMed (publishedVersion)
University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
Open access LMU (Ludwid Maxmilian's Universitat Munchen) (submittedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords: treatment preferences, patient choice, sertraline, cognitive behavioral therapy, group therapy, depression, primary care, antidepressants, psychotherapy, treatment outcomes, patient expectations
MeSH terms: Adult, Depressive Disorder, Female, Germany, Humans, Male, Middle Aged, Primary Health Care, Regression Analysis, Cognitive Behavioral Therapy, Treatment Outcome, Selective Serotonin Reuptake Inhibitors, Sertraline, Patient Preference

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Are treatment preferences relevant in response to serotonergic antidepressants and cognitive-behavioral therapy in depressed primary care patients? Results from a randomized controlled trial including a patients' choice arm

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