The Impact of Direct-to-Consumer Advertising on Health-Seeking Behavior for Depressive Symptoms

As a result of direct-to-consumer advertising (DTCA) about the availability of antidepressant medications, some consumers with depressive symptoms request antidepressants from medical doctors (MD). The illness representation (IR) model posits the lay public uses a prototype-matching system to match symptom sets with illness labels and treatment. This system works well, except when symptoms overlap related conditions. DTCA focuses on matching overlapping symptoms of many mood conditions to a depression label and a MD to ask for an antidepressant. The lay public IR for depressive symptoms may have been modified to match DTCA goals. Antidepressants alone are not the most effective treatment for clinical depression or other mood disorders. A quantitative experimental study with 2 independent variables---an illness label prime (3 levels) and a symptom vignette (2 levels), was conducted with 361 participants to determine if treatment and practitioner were predictable based on DTCA. Multinomial logistic regression analysis revealed no effect of prime or vignette on treatment or practitioner choice. Sample IRs were not biased toward DTCA advice for treatment; though across all prime and vignette conditions, 58.6% of participants choose MD as the practitioner. Additional analyses showed a significant effect of education level and experience with a mood disorder diagnosis on treatment but not practitioner choice across all experimental conditions. Findings suggest additional streams of cultural information affect health-seeking behavioral choices. Recommendations for social change include education about positive effects of mental health therapy at the high school science level; further collaboration between MD's and mental health providers, and further study regarding health insurance effects on practitioner choice.