Revealing hidden depression in older people: a qualitative study within a randomised controlled trial

BMC Family Practice

Research Article

Carolyn Chew-Graham¹  Karen Overend²  Helen Lewis²  Katharine Bosanquet²  Deborah Foster²  Della Bailey²  Rebecca Woodhouse²  Samantha Gascoyne²  Simon Gilbody²  Sarah Nutbrown² 

[1] Research Institute, Primary Care and Health Sciences, NIHR CLAHRC West Midlands, ST5 5BG, Keele, Staffordshire, UK;University of York, Heslington, YO10 5DD, York, UK;

关键词: Depression;    Older people;    Collaborative care;    Primary care;    Qualitative method;   

DOI  :  10.1186/s12875-015-0362-2

 received in 2015-07-09, accepted in 2015-10-07,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThe prevalence of depressive symptoms in older people may be as high as 20 %. Depression in older people is associated with loss, loneliness and physical co-morbidities; it is known to be under-diagnosed and under-treated. Older people may find it difficult to speak to their GPs about low mood, and GPs may avoid identifying depression due to limited consultation time and referral options for older patients.MethodsA nested qualitative study in a randomised controlled trial for older people with moderate to severe depression: the CASPER Plus Trial (Collaborative Care for Screen Positive Elders). We interviewed GPs, case managers (CM) and patient participants to explore perspectives and experiences of delivering and receiving a psychosocial intervention, developed specifically for older adults in primary care, within a collaborative care framework. Transcripts were analysed thematically using principles of constant comparison.ResultsThirty three interviews were conducted and, across the three data-sets, four main themes were identified: revealing hidden depression, reducing the ‘blind spots’, opportunity to talk outside the primary care consultation and ‘moving on’ from depression.ConclusionsDepression in older people is commonly hidden, and may coexist with physical conditions that are prioritised by both patients and GPs. Being invited to participate in a trial about depression may allow older people to disclose their feelings, name the problem, and seek help. Offering older people an opportunity to talk outside the primary care consultation is valued by patients and GPs. A psychosocial intervention delivered by a case manager in the primary care setting may fill the gap in the care of older people with depression.Trial registrationCurrent Controlled Trials ISRCTN45842879.

【 授权许可】

CC BY   
© Overend et al. 2015