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Experience of depression in older adults with and without a physical long-term condition: Findings from a qualitative interview study

Poole, L, Frost, R, Rowlands, H and Black, G (2022) Experience of depression in older adults with and without a physical long-term condition: Findings from a qualitative interview study. BMJ Open, 12 (2). ISSN 2044-6055

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Objective To understand how the lived experience of depression differs among patients with a long-term condition (LTC) compared with those without an LTC, and how the experience differs across different types of LTC. Design Face-to-face, semistructured interviews. Setting Primary care; General Practitioner (GP) surgeries in and around North London. Participants 41 primary care patients with depression were recruited. Our sample comprised participants aged 55-75 years with depression only (n=12), depression and coronary heart disease (n=5), depression and type 2 diabetes (n=10) and depression and arthritis (n=14). Results Interviews were conducted, audio recorded, transcribed and analysed using thematic analysis. The results revealed that the cardinal diagnostic symptoms of depression (anhedonia, sadness) were experienced by all our participants regardless of LTC. However, the LTC did interact with depression by compounding somatic, cognitive and emotional symptoms, increasing disability and reducing independence, and hindering attempts at coping with mental illness. Our findings demonstrate common experiences across patients as well as key differences based on LTC. Conclusions We suggest four key implications for future care practices of these patients: (1) not all participants with depression and LTC view their mental and physical health as interconnected; there should be allowances in care plans for separate treatment pathways; (2) key features of depression that affect LTC management are social withdrawal and lack of motivation to self-manage or access healthcare; (3) key features of LTCs that worsen depression are pain, the unpredictability of future health and progressive disability; (4) positive self-management of LTC could improve self-efficacy and therefore mood, and should be encouraged.

Item Type: Article
Uncontrolled Keywords: Humans; Diabetes Mellitus, Type 2; Depression; Mental Disorders; Qualitative Research; Aged; General Practitioners; coronary heart disease; depression & mood disorders; diabetes & endocrinology; qualitative research; rheumatology; Aged; Depression; Diabetes Mellitus, Type 2; General Practitioners; Humans; Mental Disorders; Qualitative Research; 1103 Clinical Sciences; 1117 Public Health and Health Services; 1199 Other Medical and Health Sciences
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions: Nursing & Allied Health
Publisher: BMJ
SWORD Depositor: A Symplectic
Date Deposited: 05 Dec 2023 14:29
Last Modified: 05 Dec 2023 14:30
DOI or ID number: 10.1136/bmjopen-2021-056566
URI: https://researchonline.ljmu.ac.uk/id/eprint/22031
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