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David C. Mohr, PhD; Donald E. Goodkin, MD; William Likosky, MD; Nicole Gatto; Kristen A. Baumann, MA; Richard A. Rudick, MD

Arch Neurol. 1997;54(5):531-533.

Abstract
Objectives
To examine the relationship between patient-reported depression and adherence to therapy with interferon beta-lb (IFNβ-1b) and to test the hypothesis that treatment of depression is associated with improved adherence.

Design
Patients with multiple sclerosis were followed up 6 months after initiating therapy with IFNβ-1b. Setting: A university outpatient multiple sclerosis center, an academic group practice, and a health maintenance organization.

Patients
Eighty-five patients with clinically evident multiple sclerosis taking IFNβ-1b.

Main Outcome Measure
Follow-up questionnaire.

Results
Thirty-five (41%) of the 85 patients reported new or increased depression within 6 months of initiating therapy with IFNβ-1b. Patients experiencing symptoms of depression were more likely to discontinue therapy. Among the patients reporting new or increased depression, 86% who received psychotherapy or antidepressant medication and 38% of the patients who received no therapy for depression continued the IFNβ-1b therapy (P=.003). Although psychotherapy was used as a treatment option more frequently in university and academic group practice—based multiple sclerosis clinics than in the health maintenance organization (P=.02), the treatment adherence patterns were similar across sites.

Conclusions
These findings support previous findings that patients report increased depression after initiating therapy with IFNβ-1b. Although the source of this depression is unclear, these findings suggest that treating patient-reported depression increases adherence to treatment.

Author Affiliations
From the University of California, San Francisco (Drs Mohr and Goodkin and Ms Gatto); Pacific Graduate School of Psychology, Palo Alto, Calif (Dr Mohr and Ms Baumann); Kaiser Permanente Medical Care Group of Northern California, Oakland (Dr Likosky); and the Cleveland Clinic Foundation, Cleveland, Ohio (Dr Rudick).

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