Do illness beliefs predict uptake of depression treatment after web-based depression screening? A secondary analysis of the DISCOVER RCT
Background Only a minority of those with depressive disorder receive treatment. Besides system-level factors, individual factors could account for the gap between detection and treatment of depression in so far unreached but affected populations.Objective This study tests the predictive value of ill...
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BMJ Publishing Group
2025-07-01
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| Series: | BMJ Mental Health |
| Online Access: | https://mentalhealth.bmj.com/content/28/1/e301666.full |
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| author | Sebastian Kohlmann Bernd Loewe Matthias Klee Franziska Sikorski |
| author_facet | Sebastian Kohlmann Bernd Loewe Matthias Klee Franziska Sikorski |
| author_sort | Sebastian Kohlmann |
| collection | DOAJ |
| description | Background Only a minority of those with depressive disorder receive treatment. Besides system-level factors, individual factors could account for the gap between detection and treatment of depression in so far unreached but affected populations.Objective This study tests the predictive value of illness beliefs (IB) for the uptake of depression treatment 6 months after web-based depression screening.Methods This is a secondary analysis of the randomised controlled Germany-wide DISCOVER trial that investigated the effects of automated results feedback following web-based depression screening in untreated participants with at least moderate depression severity (Patient Health Questionnaire ≥10 points). IB were examined as predictors of depression treatment uptake. Eligible participants were at least 18 years old, reported proficiency in German language, and provided informed consent. IB were assessed at the time of screening (baseline) with an adapted version of the Brief Illness Perception Questionnaire. Uptake of depression treatment was operationalised as self-reported initialisation of psychotherapy and/or antidepressant medication 6 months after baseline. Analyses were adjusted for study arm.Findings Data from N=871 participants of the DISCOVER trial providing follow-up data were analysed. IB denoting more consequences (OR (95% CI) 1.12 (1.00 to 1.26)), higher treatment control (OR (95% CI) 1.19 (1.11 to 1.29)) and a depression-conforming illness identity (OR (95% CI) 1.65 (1.15 to 2.36)) were associated with up to 56.8% relative increase in predicted probability of depression treatment uptake 6 months after baseline.Conclusions Results suggest considerable effects of IB for depression treatment uptake in untreated populations.Clinical implications IB could reflect relevant barriers in access to depression care and, concurrently, intervention targets to foster health service utilisation in untreated populations. |
| format | Article |
| id | doaj-art-91aba10073b649e5888692e6349de772 |
| institution | DOAJ |
| issn | 2755-9734 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Mental Health |
| spelling | doaj-art-91aba10073b649e5888692e6349de7722025-08-20T02:45:27ZengBMJ Publishing GroupBMJ Mental Health2755-97342025-07-0128110.1136/bmjment-2025-301666Do illness beliefs predict uptake of depression treatment after web-based depression screening? A secondary analysis of the DISCOVER RCTSebastian Kohlmann0Bernd Loewe1Matthias Klee2Franziska Sikorski3Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, GermanyDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, GermanyDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyBackground Only a minority of those with depressive disorder receive treatment. Besides system-level factors, individual factors could account for the gap between detection and treatment of depression in so far unreached but affected populations.Objective This study tests the predictive value of illness beliefs (IB) for the uptake of depression treatment 6 months after web-based depression screening.Methods This is a secondary analysis of the randomised controlled Germany-wide DISCOVER trial that investigated the effects of automated results feedback following web-based depression screening in untreated participants with at least moderate depression severity (Patient Health Questionnaire ≥10 points). IB were examined as predictors of depression treatment uptake. Eligible participants were at least 18 years old, reported proficiency in German language, and provided informed consent. IB were assessed at the time of screening (baseline) with an adapted version of the Brief Illness Perception Questionnaire. Uptake of depression treatment was operationalised as self-reported initialisation of psychotherapy and/or antidepressant medication 6 months after baseline. Analyses were adjusted for study arm.Findings Data from N=871 participants of the DISCOVER trial providing follow-up data were analysed. IB denoting more consequences (OR (95% CI) 1.12 (1.00 to 1.26)), higher treatment control (OR (95% CI) 1.19 (1.11 to 1.29)) and a depression-conforming illness identity (OR (95% CI) 1.65 (1.15 to 2.36)) were associated with up to 56.8% relative increase in predicted probability of depression treatment uptake 6 months after baseline.Conclusions Results suggest considerable effects of IB for depression treatment uptake in untreated populations.Clinical implications IB could reflect relevant barriers in access to depression care and, concurrently, intervention targets to foster health service utilisation in untreated populations.https://mentalhealth.bmj.com/content/28/1/e301666.full |
| spellingShingle | Sebastian Kohlmann Bernd Loewe Matthias Klee Franziska Sikorski Do illness beliefs predict uptake of depression treatment after web-based depression screening? A secondary analysis of the DISCOVER RCT BMJ Mental Health |
| title | Do illness beliefs predict uptake of depression treatment after web-based depression screening? A secondary analysis of the DISCOVER RCT |
| title_full | Do illness beliefs predict uptake of depression treatment after web-based depression screening? A secondary analysis of the DISCOVER RCT |
| title_fullStr | Do illness beliefs predict uptake of depression treatment after web-based depression screening? A secondary analysis of the DISCOVER RCT |
| title_full_unstemmed | Do illness beliefs predict uptake of depression treatment after web-based depression screening? A secondary analysis of the DISCOVER RCT |
| title_short | Do illness beliefs predict uptake of depression treatment after web-based depression screening? A secondary analysis of the DISCOVER RCT |
| title_sort | do illness beliefs predict uptake of depression treatment after web based depression screening a secondary analysis of the discover rct |
| url | https://mentalhealth.bmj.com/content/28/1/e301666.full |
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