TY - JOUR
T1 - Feeling labeled, judged, lectured, and rejected by family and friends over depression
T2 - Cautionary results for primary care clinicians from a multi-centered, qualitative study
AU - Y-Garcia, Erik Fernandez
AU - Duberstein, Paul
AU - Paterniti, Debora A.
AU - Cipri, Camille S.
AU - Kravitz, Richard L.
AU - Epstein, Ronald M.
PY - 2012
Y1 - 2012
N2 - Background: Family and friends may help patients seek out and engage in depression care. However, patients social networks can also undermine depression treatment and recovery. In an effort to improve depression care in primary care settings, we sought to identify, categorize, and alert primary care clinicians to depression-related messages that patients hear from friends and family that patients perceive as unhelpful or detrimental. Methods. We conducted 15 focus groups in 3 cities. Participants (n=116) with a personal history or knowledge of depression responded to open-ended questions about depression, including self-perceived barriers to care-seeking. Focus group conversations were audio-recorded and analyzed using iterative qualitative analysis. Results: Four themes emerged related to negatively-received depression messages delivered by family and friends. Specifically, participants perceived these messages as making them feel labeled, judged, lectured to, and rejected by family and friends when discussing depression. Some participants also expressed their interpretation of their families motivations for delivering the messages and described how hearing these messages affected depression care. Conclusions: The richness of our results reflects the complexity of communication within depression sufferers social networks around this stigmatized issue. To leverage patients social support networks effectively in depression care, primary care clinicians should be aware of both the potentially beneficial and detrimental aspects of social support. Specifically, clinicians should consider using open-ended queries into patients experiences with discussing depression with family and friends as an initial step in the process. An open-ended approach may avoid future emotional trauma or stigmatization and assist patients in overcoming self-imposed barriers to depression discussion, symptom disclosure, treatment adherence and follow-up care.
AB - Background: Family and friends may help patients seek out and engage in depression care. However, patients social networks can also undermine depression treatment and recovery. In an effort to improve depression care in primary care settings, we sought to identify, categorize, and alert primary care clinicians to depression-related messages that patients hear from friends and family that patients perceive as unhelpful or detrimental. Methods. We conducted 15 focus groups in 3 cities. Participants (n=116) with a personal history or knowledge of depression responded to open-ended questions about depression, including self-perceived barriers to care-seeking. Focus group conversations were audio-recorded and analyzed using iterative qualitative analysis. Results: Four themes emerged related to negatively-received depression messages delivered by family and friends. Specifically, participants perceived these messages as making them feel labeled, judged, lectured to, and rejected by family and friends when discussing depression. Some participants also expressed their interpretation of their families motivations for delivering the messages and described how hearing these messages affected depression care. Conclusions: The richness of our results reflects the complexity of communication within depression sufferers social networks around this stigmatized issue. To leverage patients social support networks effectively in depression care, primary care clinicians should be aware of both the potentially beneficial and detrimental aspects of social support. Specifically, clinicians should consider using open-ended queries into patients experiences with discussing depression with family and friends as an initial step in the process. An open-ended approach may avoid future emotional trauma or stigmatization and assist patients in overcoming self-imposed barriers to depression discussion, symptom disclosure, treatment adherence and follow-up care.
KW - depression
KW - disclosure
KW - norms
KW - patient-provider communication
KW - qualitative analysis
KW - social support
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U2 - 10.1186/1471-2296-13-64
DO - 10.1186/1471-2296-13-64
M3 - Article
C2 - 22747989
AN - SCOPUS:84869091871
VL - 13
JO - BMC Family Practice
JF - BMC Family Practice
SN - 1471-2296
M1 - 64
ER -