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Primary care professionals' perceptions of depression in older people: a qualitative study

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  • Murray, Joanna
  • Banerjee, Sube
  • Byng, Richard
  • Tylee, Andre
  • Bhugra, Dinesh
  • Macdonald, Alastair

Abstract

An understanding of patients' perspectives is crucial to improving engagement with health care services. For older people who may not wish to bother medical professionals with problems of living such as depression, such exploration becomes critical. General practitioners (GPs), nurses and counsellors working in 18 South London primary care teams were interviewed about their perceptions of depression in older people. All three professional groups shared a predominantly psychosocial model of the causes of depression. While presentation of somatic symptoms was seen as common in all age groups, identification of depression in older patients was complicated by co-existent physical illnesses. GPs reported that older patients rarely mentioned psychological difficulties, but practice nurses felt that older people were less inhibited in talking to them about "non-medical" problems. Many older people were perceived to regard symptoms of depression as a normal consequence of ageing and not to think it appropriate to mention non-physical problems in a medical consultation. Men were thought to be particularly reluctant to disclose emotional distress and were more vulnerable to severe depression and suicide. Some GPs had mixed feelings about offering medication to address what they believed to be the consequences of loneliness and social isolation. Participants thought that many older people regard depression as a "sign of weakness" and the perceived stigma of mental illness was widely recognised as a barrier to seeking help. Cultural variations in illness beliefs, especially the attribution of symptoms, were thought to profoundly influence the help-seeking behaviour of elders from minority ethnic groups. Families were identified as the main source of both support and distress; and as such their influence could be crucial to the identification and treatment of depression in older people.

Suggested Citation

  • Murray, Joanna & Banerjee, Sube & Byng, Richard & Tylee, Andre & Bhugra, Dinesh & Macdonald, Alastair, 2006. "Primary care professionals' perceptions of depression in older people: a qualitative study," Social Science & Medicine, Elsevier, vol. 63(5), pages 1363-1373, September.
  • Handle: RePEc:eee:socmed:v:63:y:2006:i:5:p:1363-1373
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    References listed on IDEAS

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    1. Prior, Lindsay & Wood, Fiona & Lewis, Glyn & Pill, Roisin, 2003. "Stigma revisited, disclosure of emotional problems in primary care consultations in Wales," Social Science & Medicine, Elsevier, vol. 56(10), pages 2191-2200, May.
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    Cited by:

    1. Bennion, Amy E. & Shaw, Rachel L. & Gibson, Jonathan M., 2012. "What do we know about the experience of age related macular degeneration? A systematic review and meta-synthesis of qualitative research," Social Science & Medicine, Elsevier, vol. 75(6), pages 976-985.
    2. McPherson, Susan & Armstrong, David, 2009. "Negotiating 'depression' in primary care: A qualitative study," Social Science & Medicine, Elsevier, vol. 69(8), pages 1137-1143, October.

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    Keywords

    Old age Depression Primary care UK;

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