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BMC Primary Care
Published in: BMC Primary Care 1/2015

Open Access 01-12-2015 | Research article

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

Authors: Karen Overend, Katharine Bosanquet, Della Bailey, Deborah Foster, Samantha Gascoyne, Helen Lewis, Sarah Nutbrown, Rebecca Woodhouse, Simon Gilbody, Carolyn Chew-Graham

Published in: BMC Primary Care | Issue 1/2015

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Abstract

Background

The 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.

Methods

A 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.

Results

Thirty 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.

Conclusions

Depression 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 registration

Current Controlled Trials ISRCTN45842879.
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Metadata
Title
Revealing hidden depression in older people: a qualitative study within a randomised controlled trial
Authors
Karen Overend
Katharine Bosanquet
Della Bailey
Deborah Foster
Samantha Gascoyne
Helen Lewis
Sarah Nutbrown
Rebecca Woodhouse
Simon Gilbody
Carolyn Chew-Graham
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2015
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-015-0362-2

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