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- Title
How patients understand depression associated with chronic physical disease - a systematic review.
- Authors
Alderson, Sarah L; Foy, Robbie; Glidewell, Liz; McLintock, Kate; House, Allan
- Abstract
Background: Clinicians are encouraged to screen people with chronic physical illness for depression. Screening alone may not improve outcomes, especially if the process is incompatible with patient beliefs. The aim of this research is to understand people's beliefs about depression, particularly in the presence of chronic physical disease. Methods: A mixed method systematic review involving a thematic analysis of qualitative studies and quantitative studies of beliefs held by people with current depressive symptoms. MEDLINE, EMBASE, PSYCHINFO, CINAHL, BIOSIS, Web of Science, The Cochrane Library, UKCRN portfolio, National Research Register Archive, Clinicaltrials.gov and OpenSIGLE were searched from database inception to 31st December 2010. A narrative synthesis of qualitative and quantitative data, based initially upon illness representations and extended to include other themes not compatible with that framework. Results: A range of clinically relevant beliefs was identified from 65 studies including the difficulty in labeling depression, complex causal factors instead of the biological model, the roles of different treatments and negati veviews about the consequences of depression. We found other important themes less related to ideas about illness: the existence of a self-sustaining 'depression spiral'; depression as an existential state; the ambiguous status of suicidal thinking; and the role of stigma and blame in depression. Conclusions: Approaches to detection of depression in physical illness need to be receptive to the range of beliefs held by patients. Patient beliefs have implications for engagement with depression screening.
- Subjects
CHRONIC diseases; CINAHL database; MENTAL depression; MEDICAL databases; INFORMATION storage &; retrieval systems; MEDICAL information storage &; retrieval systems; PSYCHOLOGY information storage &; retrieval systems; MEDLINE; SYSTEMATIC reviews; PATIENTS' attitudes; DISEASE complications
- Publication
BMC Family Practice, 2012, Vol 13, Issue 1, p41
- ISSN
1471-2296
- Publication type
Article
- DOI
10.1186/1471-2296-13-41