Patients' explanations for depression: a factor analytic study

Budd, Rick; James, Darren; Hughes, Ian

doi:10.1002/cpp.558

Cited by 15 publications

(14 citation statements)

References 13 publications

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“…[7, 8, 10, 11, 14, 19, 20, 21]), because attention was payed to the causal beliefs most important from the patients’ perspective.…”

Section: Discussionmentioning

confidence: 99%

“…Mentally ill patients’ causal beliefs were most commonly measured through questionnaires and patients rate each cause from a giving list as regards to how much they agree with it (e.g. [7, 8, 10, 11, 14, 19, 20, 21]). In these studies, patients diagnosed with mental disorders agreed with a variety of causal beliefs including biological (e.g.…”

Section: Introductionmentioning

confidence: 99%

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What Do Patients Think about the Cause of Their Mental Disorder? A Qualitative and Quantitative Analysis of Causal Beliefs of Mental Disorder in Inpatients in Psychosomatic Rehabilitation

2017

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BackgroundPatients’ causal beliefs about their mental disorders are important for treatment because they affect illness-related behaviours. However, there are few studies exploring patients’ causal beliefs about their mental disorder.Objectives(a) To qualitatively explore patients’ causal beliefs of their mental disorder, (b) to explore frequencies of patients stating causal beliefs, and (c) to investigate differences of causal beliefs according to patients’ primary diagnoses.MethodInpatients in psychosomatic rehabilitation were asked an open-ended question about their three most important causal beliefs about their mental illness. Answers were obtained from 678 patients, with primary diagnoses of depression (N = 341), adjustment disorder (N = 75), reaction to severe stress (N = 57) and anxiety disorders (N = 40). Two researchers developed a category system inductively and categorised the reported causal beliefs. Qualitative analysis has been supplemented by logistic regression analyses.ResultsThe causal beliefs were organized into twelve content-related categories. Causal beliefs referring to “problems at work” (47%) and “problems in social environment” (46%) were most frequently mentioned by patients with mental disorders. 35% of patients indicate causal beliefs related to “self/internal states”. Patients with depression and patients with anxiety disorders stated similar causal beliefs, whereas patients with reactions to severe stress and adjustment disorders stated different causal beliefs in comparison to patients with depression.LimitationsThere was no opportunity for further exploration, because we analysed written documents.ConclusionsThese results add a detailed insight to mentally ill patients’ causal beliefs to illness perception literature. Additionally, evidence about differences in frequencies of causal beliefs between different illness groups complement previous findings. For future research it is important to clarify the relation between patients’ causal beliefs and the chosen treatment.

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“…[7, 8, 10, 11, 14, 19, 20, 21]), because attention was payed to the causal beliefs most important from the patients’ perspective.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

What Do Patients Think about the Cause of Their Mental Disorder? A Qualitative and Quantitative Analysis of Causal Beliefs of Mental Disorder in Inpatients in Psychosomatic Rehabilitation

2017

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“…These include traumatic events in childhood and adulthood, stressful life events, inability to cope, personality, and heredity. Few patients considered biological factors to be relevant [3, 7–9], whilst some report a belief that depression is not a ‘real illness’ or that it is a way of medicalizing a normal human experience [10]. …”

Section: Causal Beliefs For the Onset Of Depressionmentioning

confidence: 99%

“…For example, it has been suggested that patients who take on a biological understanding of their depression—possibly seeing it as something ‘inherited from my dad’ or as ‘a problem with my synapses’—may find pharmacological treatment preferable to psychological therapies [3]. This has been supported by findings that patients who view their depression as chronic are more compliant with medication, whereas medication adherence is poorer in patients who consider their depression to be caused by relationship problems [4, 5].…”

Section: Introductionmentioning

confidence: 99%

“Did I bring it on myself?” An exploratory study of the beliefs that adolescents referred to mental health services have about the causes of their depression

Midgley

Parkinson

Holmes

et al. 2016

Eur Child Adolesc Psychiatry

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The causal beliefs which adults have regarding their mental health difficulties have been linked to help-seeking behaviour, treatment preferences, and the outcome of therapy; yet, the topic remains a relatively unexplored one in the adolescent literature. This exploratory study aims to explore the causal beliefs regarding depression among a sample of clinically referred adolescents. Seventy seven adolescents, aged between 11 and 17, all diagnosed with moderate to severe depression, were interviewed using a semi-structured interview schedule, at the beginning of their participation in a randomised controlled trial. Data were analysed qualitatively using framework analysis. The study identified three themes related to causal beliefs: (1) bewilderment about why they were depressed; (2) depression as a result of rejection, victimisation, and stress; and (3) something inside is to blame. Although some adolescents struggled to identify the causes of their depression, many identified stressful life experiences as the cause of their current depression. They also tended to emphasise their own negative ways of interpreting those events, and some believed that their depression was caused by something inside them. Adolescents’ causal beliefs are likely to have implications for the way they seek help and engage in treatment, making it important to understand how adolescents understand their difficulties.

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“…In particular, disagreement about biomedical causation of depression was associated with rejection of a depression diagnosis (Van Voorhees et al, 2005), while agreement over biological causes of depression correlated with belief in the efficacy of medication (Budd, James, & Hughes, 2008).…”

Section: Discussionmentioning

confidence: 99%

Depression explanatory models of primary care patients and doctors: Relationship with self-stigma, communication effectiveness, and recovery

Teh¹

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This thesis examines the role of patient and doctor perspectives in primary care depression management. The analytical term chosen to explore these perspectives is Kleinman's explanatory model (EM), defined as "notions about an episode of sickness and its treatment that are employed by all those engaged in the clinical process" (1980, p. 105). This research is exploratory and focuses mainly on patients, with input from a small number of general practitioners (GPs).I examine self-stigma in depression patients because there has been an attempt in recent years to reduce stigma by describing depression as a medical condition like diabetes. This may have decreased some public stigma, but the association between biomedical explanations for depression and patient self-stigma has not been studied in-depth. Self-stigma is the internalisation of negative stereotypes and prejudices about having mental illness and it can inhibit help-seeking and outcomes more than public stigma. Another factor that can influence depression outcomes is the therapeutic relationship between patient and their doctor. Studies report empathy and good communication as Quantitative analysis methods mainly consisted of non-parametric tests for differences between groups and strength of correlations. Interviews were analysed manually and with textual analysis software Leximancer.RQ1 results showed that most participants had a strong or moderate belief about whether biomedical and/or psychosocial factors caused their depression, and most EM beliefs did not change over time. RQ2 results indicated that biomedical belief was associated with lower helpseeking inhibition but also greater alienation. RQ3 results highlighted that endorsement of GPpatient cooperation was strongly positively correlated with communication effectiveness. Patient interviews yielded exemplars to illustrate these findings. RQ4 results from a paired study (n = 29) suggest that the GPs were aware of and concordant with their patient's EMs. Awareness appears to be more important in determining recovery than concordance. Incidentally, GP interviews showed that doctors mostly accorded importance to knowing their patient's EM but concordance was seen as less crucial.This thesis gives new understanding about depression EM beliefs that are associated with lower patient self-stigma and more effective GP-patient communication. Results from this research on awareness-concordance were not generalisable due to the small sample size, but future work with larger samples will undoubtedly yield more insights into the importance of EMs in primary care depression management.

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Patients' explanations for depression: a factor analytic study

Cited by 15 publications

References 13 publications

What Do Patients Think about the Cause of Their Mental Disorder? A Qualitative and Quantitative Analysis of Causal Beliefs of Mental Disorder in Inpatients in Psychosomatic Rehabilitation

What Do Patients Think about the Cause of Their Mental Disorder? A Qualitative and Quantitative Analysis of Causal Beliefs of Mental Disorder in Inpatients in Psychosomatic Rehabilitation

“Did I bring it on myself?” An exploratory study of the beliefs that adolescents referred to mental health services have about the causes of their depression

Depression explanatory models of primary care patients and doctors: Relationship with self-stigma, communication effectiveness, and recovery

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