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BMC Psychiatry
Published in: BMC Psychiatry 1/2017

Open Access 01-12-2017 | Research article

An ethnographic study of the effects of cognitive symptoms in patients with major depressive disorder: the IMPACT study

Authors: Bjarke Ebert, Kamilla Miskowiak, Morten Kloster, Jon Johansen, Cara Eckholm, Torbjörn Wærner, Mads Holme, Louise Meldgaard Bruun

Published in: BMC Psychiatry | Issue 1/2017

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Abstract

Background

The manifestation of major depressive disorder (MDD) may include cognitive symptoms that can precede the onset of MDD and persist beyond the resolution of acute depressive episodes. However, little is known about how cognitive symptoms are experienced by MDD patients and the people around them.

Methods

In this international (Brazil, Canada, China, France, and Germany) ethnographic study, we conducted semi-structured interviews and observations of remitted as well as symptomatic MDD patients (all patients self-reported being diagnosed by an HCP and self-reported being on an antidepressant) aged 18–60 years with self-reported cognitive symptoms (N = 34). In addition, participating depressed patients’ close family or friends (N = 31) were interviewed. Separately recruited from depressed participants, work colleagues (N = 21) and healthcare providers (HCPs; N = 13) of depressed individuals were interviewed.

Results

Key insights were that: (1) patients were generally unaware that their cognitive symptoms were linked to their depression and, instead, attributed these symptoms to negative aspects of their person (e.g., age, separate disease, laziness, exhaustion); (2) cognitive symptoms in MDD appeared to negatively impact patients’ social relationships and patients’ ability to handle daily tasks at work and at home; (3) patients’ cognitive symptoms also impacted relationships with family members and coworkers; (4) patients’ cognitive symptoms increased stress and feelings of failure, which in turn seemed to worsen the cognitive symptoms, thereby creating a destructive cycle; and (5) although HCPs recommended that patients re-engage in everyday activities to help overcome their depression, cognitive symptoms seemed to impede such functional recovery.

Conclusions

Taken together, these findings highlight a negative impact of patients’ cognitive symptoms on their social functioning, work performance, and quality of life on the people close to them, and consequently on the degree of functional recovery after depression.
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Metadata
Title
An ethnographic study of the effects of cognitive symptoms in patients with major depressive disorder: the IMPACT study
Authors
Bjarke Ebert
Kamilla Miskowiak
Morten Kloster
Jon Johansen
Cara Eckholm
Torbjörn Wærner
Mads Holme
Louise Meldgaard Bruun
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-017-1523-8

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