Table 3 Implications derived from themes
From: How patients understand depression associated with chronic physical disease – a systematic review
Theme | Implications |
|---|---|
Identity | How patients think about depression and about being given a label or diagnosis for it may be important in understanding why patients engage or do not engage in detection. |
Cause | Mismatches in what patients and GPs believe causes depression may undermine the development of shared treatment plans and undermine subsequent concordance. |
Cure &/or Control | Beliefs about the role and relevance of antidepressants or psychotherapy may affect whether patients wish to have depressive symptoms detected. |
Timeline | Patient beliefs about the course of their depression will affect detection. Those who expect quick resolution may not think it to be appropriate to seek treatment. |
Consequences | Negative views about the consequences of having depression may lead to hopelessness or defensiveness in the face of attempts at standardised depression detection. |
Coherence | Identifying how the patient thinks can be difficult in consultations, but it will be important to identify and if possible moderate beliefs if they are not helpful to recovery. |
Depression Cycle | The cyclical beliefs leave patients feeling a sense of futility about long term approaches to intervention. |
Existential & Self | Discussing what depression means to how patients perceive themselves may increase acceptance by a patient that depression can be a concern of clinicians. |
Role of suicide | While suicidal acts are relatively rare, suicidal thoughts are relatively common. Exploring the latter is best with an open mind towards their meaning for the patient. |
Stigma, blame & responsibility | Presenting screening as a normal and routine part of care may help reduce feelings of shame and “give permission” to discuss depression. |