چکیده (انگلیسی):

Background:Detection of depression can be difficult in primary care, particularly when associated with chronic
illness. Patient beliefs may affect detection and subsequent engagement with management. We explored patient
beliefs about the nature of depression associated with physical illness.
Methods:A qualitative interview study of patients registered with general practices in Leeds, UK. We invited
patients with coronary heart disease or diabetes from primary care to participate in semi-structured interviews
exploring their beliefs and experiences. We analysed transcripts using a thematic approach, extended to consider
narratives as important contextual elements.
Results:We interviewed 26 patients, including 17 with personal experience of depression. We developed six
themes: recognising a problem, complex causality, the role of the primary care, responsibility, resilience, and the
role of their life story. Participants did not consistently talk about depression as an illness-like disorder. They
described a change in their sense of self against the background of their life stories. Participants were unsure about
seeking help from general practitioners (GPs) and felt a personal responsibility to overcome depression themselves.
Chronic illness, as opposed to other life pressures, was seen as a justifiable cause of depression.
Conclusions:People with chronic illness do not necessarily regard depression as an easily defined illness, especially
outside of the context of their life stories. Efforts to engage patients with chronic illness in the detection and
management of depression may need further tailoring to accommodate beliefs about how people view
themselves, responsibility and negative views of treatment