Motivational Interviewing to Improve Medication Adherence Among Hispanic Adults With Depression

Depression is a serious mental illness characterized by symptoms that can interfere with a
person's ability to work, study, eat, sleep, and enjoy activities that were once
pleasurable. Studies have shown that people of Hispanic descent tend to underutilize mental
health care services. Additionally, Hispanics have demonstrated lower compliance and
completion rates for antidepressant treatment. This may be due to low socioeconomic status,
lack of family financial support, and inadequate communication with mental health care
providers. Motivational interviewing is a goal-oriented type of therapy that focuses on
eliciting behavior change by identifying and mobilizing a person's values. This study will
determine the effectiveness of culturally sensitive motivational interviewing in improving
antidepressant medication adherence in Hispanics.

Participants in this 6-month, open-label study will be randomly assigned to receive either
motivational interviewing in addition to their antidepressant therapy or treatment as usual.
All participants will first attend a 45-minute screening visit, which will include
questionnaires and an interview about psychiatric symptoms, medication attitudes, and
medication adherence behavior. Participants will also receive an electronic medication
container that will record how consistently medication is taken. Participants assigned to
motivational interviewing will then attend two 1-hour sessions of motivational interviewing
over 2 consecutive weeks, followed by a third session 8 weeks later. The group assigned to
treatment as usual will not partake in motivational interviewing, but will continue to
receive their normal care. All participants will return to the study site for follow-up
assessments, which will include measures of antidepressant adherence, at Months 2 and 5.

Inclusion Criteria:

- Self-identifies as Hispanic

- DSM-IV diagnosis of any unipolar depressive disorder (i.e., MDD, dysthymia, or
depressive disorder not otherwise specified)

- Currently taking antidepressant medication

Exclusion Criteria:

- Clinically significant suicidal ideation

- DSM-IV diagnosis of any substance-related disorder, bipolar disorder, or psychotic
disorder/features within 12 months prior to study entry

- Unstable general medical condition