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Cited by 220Mental Health Treatment and AccessAging, Health, and DisabilityPsychology and Mental Health

The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.

‘Justifiable depression’: How primary care professionals and patients view late-life depression? A qualitative study

Burroughs, H.·2006·Family Practice
DOI 10.1093/fampra/cmi115
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Abstract

BACKGROUND: Depression is the commonest mental health problem in elderly people and continues to be underdiagnosed and undertreated. AIM: To explore the ways that primary care professionals and patients view the causes and management of late-life depression. DESIGN: A qualitative study using semistructured interviews. SETTING: One Primary Care Trust in North West England. PARTICIPANTS: Fifteen primary care practitioners comprising nine GPs, three practice nurses, two district nurses and one community nurse; twenty patients who were over the age of 60 and who were participating in a feasibility study of a new model of care for late-life depression [PRIDE Trial: PRimary care Intervention for Depression in the Elderly (a feasibility study in Central Manchester funded by the Department of Health)]. RESULTS: Primary care practitioners conceptualized late-life depression as a problem of their everyday work, rather than as an objective diagnostic category. They described depression as part of a spectrum including loneliness, lack of social network, reduction in function and viewed depression as 'understandable' and 'justifiable'. This view was shared by patients. Therapeutic nihilism, the feeling that nothing could be done for this group of patients, was a feature of all primary care professionals' interviews. Patients' views were characterized by passivity and limited expectations of treatment. Depression was not viewed as a legitimate illness to be taken to the GP. Primary care professionals recognized that managing late-life depression did fall within their remit, but identified limitations in their own skills and capabilities in this area, as well as a lack of other resources to which they could refer patients. CONCLUSION: This study highlights the complicated nature of the diagnosis and management of late-life depression. Protocols for the diagnosis and treatment of depression emphasis the biomedical model which does not fit with the everyday experience of GPs or elderly patients who share the views of primary care professionals that depression is a consequence of social and contextual issues. There is a need for the development of evidence-based provision for older people with depression within primary care, but also a need for elderly patients to be made aware of the legitimacy of presenting low mood and misery to their primary care professional.

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  1. 15 Callahan CM. Quality improvement research on late-life depression. Med Care 2001; 39: 772-784.
  2. 23 Unutzer J. Diagnosis and treatment of older adults with depression in primary care. Biol Psychiatry 2002; 52: 285-292.
  3. 27 Unutzer J. Diagnosis and Treatment of Older Adults with depression in Primary Care. Biological Psychiatry 2002; 52: 285-92.
  4. 31 Rait G, Burns A, Baldwin R et al . Screening for depression in older African-Caribbeans. Fam Pract 1999; 16: 591-595.
  5. 36 Unutzer J. Diagnosis and treatment of older adults with depression in primary care. Biol Psychiatry 2002; 52: 285-292.
  6. 38 Montano CB. Primary care issues related to the treatment of depression in elderly patients. J Clin Psychiatry 1999; 60: 45-51.
  7. 39 Thomas-MacLean R, Stoppard JM. Physicians constructions of depression: inside/outside the boundaries of medicalisation. Health: an interdisciplinary journal for the social study of health. Illness Med 2004; 8: 275-293.
  8. 42 Chew-Graham C, May CR, Cole H, Hedley S. The burden of depression in primary care: a qualitative investigation of general practitioners' constructs of depressed people in the inner city. Prim Care Psychiatry 2002; 6: 137-141.

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Metadata

Authors
Burroughs, H.
Affiliations
University of Manchester (GB)
Corresponding author
Burroughs, H.
ORCID
Burroughs, H.
Venue
Family Practice
Publisher
Oxford University Press (OUP)
Published
2006-02-03
Volume
23
Issue
3
Pages
369-377
ISSN
  • 0263-2136 (ISSN-L)
  • 1460-2229
DOI
10.1093/fampra/cmi115
OpenAlex
W2167068556
Cited by
220
References
32
Citations by year
2026: 1 · 2025: 4 · 2024: 10 · 2023: 6 · 2022: 8 · 2021: 12 · 2020: 11 · 2019: 15 · 2018: 15 · 2017: 11 · 2016: 13 · 2015: 11 · 2014: 16 · 2013: 8 · 2012: 19
FWCI
14.63
Type
journal article
Language
en
Open access
closed
Locations
  • Family Practice (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
  • Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
Keywords
geriatric depression, primary care providers, elderly patients, therapeutic nihilism, underdiagnosis, undertreatment, social determinants of mental health, loneliness, social networks, GP perceptions, patient help-seeking, biomedical model
MeSH terms
Anecdotes as Topic, Attitude of Health Personnel, Depressive Disorder, Female, Geriatric Psychiatry, Humans, Male, Physicians, Family, Primary Health Care, Qualitative Research

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