Stark Anne, Kaduszkiewicz Hanna, Stein Janine, Maier Wolfgang, Heser Kathrin, Weyerer Siegfried, Werle Jochen, Wiese Birgitt, Mamone Silke, König Hans-Helmut, Bock Jens-Oliver, Riedel-Heller Steffi G, Scherer Martin
Institute of General Practice/Primary Care, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Institute of General Practice, Medical Faculty, Kiel University, Michaelisstr. 5, 24105, Kiel, Germany.
BMC Fam Pract. 2018 Jan 3;19(1):2. doi: 10.1186/s12875-017-0684-3.
Depression is one of the most common mental disorders in old age and is associated with various negative health consequences for the affected individual. Studies suggest that patients' views on depression have an impact on help-seeking behaviour and treatment. It is thus important to investigate the patient's perspective in order to ascertain optimum management of depression in late life. However, studies on depression and its treatment exploring the perspectives of primary care patients 75 years or older, are rare.
Qualitative data was collected in semi-structured interviews with 12 primary care patients 75 years of age or older with symptoms of depression. Data was analysed using qualitative content analysis.
The study's results show the multifaceted views on and treatment of depression in primary care patients 75 years of age or older. Some patients seemed well informed about depression and believed in the efficacy of different treatments, such as medications or psychotherapy. However, some individuals had misconceptions about depression and its treatments. Patients mentioned that they would rather avoid talking about depression within their social network, in part of fear of negative reactions. Furthermore, participants believed that other people had little understanding for people with depression. Patients had different views on the relevance of the general practitioner's (GP) role in treating depression; some patients believed that the GP had little importance in the treatment of depression.
This study identified positive views of primary care patients 75 years of age or older towards depression as well as views that might hinder optimal treatments. Exemplary implications for an improved management of depression are: educating older adults about depression via age-specific information and having professionals encourage patients in believing that depression is a recognised disorder.
抑郁症是老年人群中最常见的精神障碍之一，会给患者带来各种负面健康后果。研究表明，患者对抑郁症的看法会影响其寻求帮助的行为和治疗。因此，为了确定老年抑郁症的最佳管理方式，调查患者的观点很重要。然而，针对75岁及以上初级保健患者对抑郁症及其治疗的观点的研究很少。
对12名75岁及以上有抑郁症状的初级保健患者进行半结构化访谈，收集定性数据。采用定性内容分析法对数据进行分析。
研究结果显示了75岁及以上初级保健患者对抑郁症的多方面看法和治疗情况。一些患者似乎对抑郁症有充分了解，并相信不同治疗方法（如药物治疗或心理治疗）的疗效。然而，一些人对抑郁症及其治疗存在误解。患者提到他们宁愿避免在社交圈子里谈论抑郁症，部分原因是担心负面反应。此外，参与者认为其他人对抑郁症患者了解甚少。患者对全科医生（GP）在治疗抑郁症中的作用的相关性有不同看法；一些患者认为全科医生在抑郁症治疗中作用不大。
本研究确定了75岁及以上初级保健患者对抑郁症的积极看法以及可能阻碍最佳治疗的看法。改善抑郁症管理的示例性建议包括：通过针对特定年龄段的信息对老年人进行抑郁症教育，让专业人员鼓励患者相信抑郁症是一种公认疾病。
