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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, Lydia; Frost, Rachael; Rowlands, Hannah; Black, Georgia; (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) , Article e056566. 10.1136/bmjopen-2021-056566. Green open access

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Abstract

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.

Type: Article
Title: Experience of depression in older adults with and without a physical long-term condition: findings from a qualitative interview study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmjopen-2021-056566
Publisher version: http://dx.doi.org/10.1136/ bmjopen-2021-056566
Language: English
Additional information: This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Applied Health Research
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10144307
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