Better Doctor-Patient Relationships Are Associated with Men Choosing More Active Depression Treatment

David Kealy; Simon M. Rice; Olivier Ferlatte; John S. Ogrodniczuk; John L. Oliffe

doi:10.3122/jabfm.2019.01.170430

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Table 1.

Sociodemographic and Descriptive Data Regarding Canadian Men with a Regular Family Physician

	Overall, (n = 819)	PHQ-9 < 10, (n = 669)	PHQ-9 10 to 14, (n = 74)	PHQ-9 ≥ 15, (n = 76)
	n (%)	n (%)	n (%)	n (%)
Employed	540 (65.9)	449 (67.1)	47 (63.5)	44 (57.9)
Retired	209 (25.5)	191 (28.6)	5 (6.8)	13 (17.1)
Student	33 (4)	18 (2.7)	7 (9.5)	8 (10.5)
Completed post-secondary education	695 (84.9)	573 (85.7)	59 (79.7)	63 (82.9)
	M (SD)	M (SD)	M (SD)	M (SD)
Age (y)	51.41 (14.38)	52.90 (15.00)	46.23 (12.25)	43.32 (15.10)
Depression (PHQ-9)	5.29 (5.78)	3.00 (2.75)	11.77 (1.36)	19.11 (3.60)
Patient-doctor relationship (PDDRS)	20.09 (7.89)	20.55 (7.79)	17.43 (7.24)	18.58 (8.75)

M, mean; PDDRS, Patient-Doctor Depth-of-Relationship Scale; PHQ-9, Patient Health Questionnaire-9; SD, standard deviation.

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Table 2.

Results of a Multinomial Logistic Regression Examining Men's Relationship with Their Family Physician and Hypothetical Choice of Treatment for Depression; Overall Sample of Men with a Family Physician (n = 819)

Reference: No treatment/wait-and-see (n = 285)	OR	95% CI	P
Medication, 6 months with possible side effects, (n = 183)
Age	0.98	0.96, 1.00	.08
Employed	1.20	0.63, 2.27	.58
Retired	1.64	0.75, 3.60	.21
Student	2.80	0.78, 10.11	.12
Level of education	0.69	0.41, 1.15	.15
Depressive symptoms	1.06	1.03, 1.10	.001
Patient-doctor depth of relationship	1.06	1.03, 1.09	<.001
Individual psychotherapy (n = 277)
Age	0.98	0.97, 1.00	.06
Employed	1.48	0.81, 2.70	.21
Retired	1.15	0.55, 2.40	.71
Student	4.92	1.54, 15.75	.007
Level of education	1.00	0.61, 1.65	.99
Depressive symptoms	0.98	0.95, 1.02	.42
Patient-doctor depth of relationship	1.04	1.02, 1.07	<.001
Group psychotherapy, (n = 74)
Age	1.01	0.97, 1.03	.98
Employed	0.71	0.31, 1.65	.43
Retired	0.99	0.36, 2.75	.99
Student	2.05	0.33, 12.64	.44
Level of education	0.81	0.40, 1.63	.55
Depressive symptoms	1.01	0.96, 1.06	.78
Patient-doctor depth of relationship	1.03	1.00, 1.07	.09

CI, confidential interval; OR, odds ratio. Bold text indicates statistically significant values.

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Table 3.

Sub-Analyses of Men's Hypothetical Choice of Treatment for Depression, Multinomial Regression by Depressive Severity

	OR	95% CI	P
Severity of depression: None to mild, PHQ-9 < 10 (n = 669)
Reference: No treatment/wait-and-see (n = 242)
Medication, 6 months with possible side effects (n = 130)
Patient-doctor depth of relationship	1.06^*	1.03–1.09	<.001
Individual psychotherapy (n = 238)
Patient-doctor depth of relationship	1.04^*	1.02–1.07	.001
Group psychotherapy (n = 59)
Patient-doctor depth of relationship	1.02^*	0.98–1.06	.27
Severity of depression: moderate, PHQ-9 ≥ 10 (n = 74)
Reference: No treatment/wait-and-see (n = 27)
Medication, 6 months with possible side effects (n = 22)
Patient-doctor depth of relationship	1.02^†	0.94–1.11	.63
Individual psychotherapy (n = 18)
Patient-doctor depth of relationship	0.96^†	0.88–1.05	.41
Group psychotherapy (n = 7)
Patient-doctor depth of relationship	1.11^†	0.97–1.26	.12
Severity of depression: moderately severe, PHQ-9 ≥ 15 (n = 76)
Reference: No treatment/wait-and-see (n = 16)
Medication, 6 months with possible side effects (n = 31)
Patient-doctor depth of relationship	1.13^†	1.04–1.24	.005
Individual psychotherapy (n = 21)
Patient-doctor depth of relationship	1.14^†	1.04–1.25	.008
Group psychotherapy (n = 8)
Patient-doctor depth of relationship	1.08^†	0.97–1.21	.17

CI, confidential interval; OR, odds ratio; PHQ-9, Patient Health Questionnaire-9. Bold text indicates statistically significant values.
↵* Odds ratios adjusted for age, employment, retirement, student status, and level of education.
↵† Odds ratios adjusted for age and employment.