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Open Access Research article

Depression diagnosis and treatment amongst multimorbid patients: a thematic analysis

Melinda N Stanners14*, Christopher A Barton2, Sepehr Shakib3 and Helen R Winefield4

Author Affiliations

1 Discipline of General Practice, Flinders University, Bedford Park, South Australia, Australia

2 Social Health Sciences Unit, Flinders University, Bedford Park, South Australia, Australia

3 Department of Clinical Pharmacology, Royal Adelaide Hospital, Adelaide, South Australia, Australia

4 School of Psychology, University of Adelaide, Adelaide, South Australia, Australia

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BMC Family Practice 2014, 15:124  doi:10.1186/1471-2296-15-124

Published: 19 June 2014

Abstract

Background

We explored experiences of depression diagnosis and treatment amongst multimorbid patients referred to a metropolitan multidisciplinary outpatient clinic to identify commonalities across this patient group.

Methods

Patients with two or more chronic conditions and a diagnosis of depression participated in semi-structured interviews that were digitally recorded and transcribed. Thematic analysis was performed on the transcriptions.

Results

Multimorbid patients attributed depressive symptoms to the loss of ‘normal’ roles and functionality and struggled to reconcile the depression diagnosis with their sense of identity. Beliefs about themselves and depression affected their receptivity to diagnosis and intervention strategies. These included prescribed interventions, such as psychotherapy or pharmacotherapy, and patient-developed strategies.

Conclusions

Functional and social role losses present a clear context in which GPs should raise the subject of mood, with the situational attribution of depression suggesting that psychotherapy, which is rarely offered, should be prioritised in these circumstances.

Keywords:
Depression; Multimorbidity; Chronic illness and disease; Patient experiences; Qualitative interviews