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Depression: The Patient Experience of Stopping Antidepressant Medication. Penny Louch 15 th November 2008. Presentation Plan. Depression in context Rationale for study Theoretical framework Study design Findings. Global Burden of Depression.
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Depression: The Patient Experience of Stopping Antidepressant Medication Penny Louch 15th November 2008
Presentation Plan • Depression in context • Rationale for study • Theoretical framework • Study design • Findings
Global Burden of Depression WHO. The World Health Report 2001. Mental Health: New Understanding, New Hope. Geneva: WHO, 2001 WHO. World Health Statistics 2006. 2006. France, WHO.
European Burden of Depression WHO. The European Health Report 2002. 2002. Copenhagen, Denmark, WHO Regional Officefor Europe.
1in 3 Families Experience Depression The Burden of Depression • Personal • Family • Social • Economic • Office for National Statistics. Psychiatric Morbidity in Great Britain, 2000, Prevalence of Psychiatric Morbidity Among Adults Living in Private Households. London: HMSO, 2001. • The Centre for Economic Performance's Mental Health Policy Group. The Depression Report: New Deal for Depression and Anxiety Disorders. London: London School of Economics, 2006.
Depression Diagnosis in Primary Care Rule of Halves Lepine JP, Gastpar M, Mendlewicz J, Tylee A. Depression in the community: The first pan-European study DEPRES (Depression Research in European Society). Int.Clin.Psychopharmacol. 1997;12:19-29.
Rationale for the Study • Previous research • Quantitative and biomedical • Few studies about stopping antidepressants
Research Questions “What is the nature of the concerns patients experience when they stop their antidepressant medication?” “Are these concerns dependent upon a personal construction of the meaning of recovery from a depressive illness?”
Kleinman 5 parts of an illness experience Explanatory Model Theory Kleinman A. Patients and healers in the context of culture. Berkeley, CA: University of California Press, 1980.
Study Design • General practice • Data collection • Questionnaire • Interviews
Questionnaire sent to 572 patients In-depth interview with 30 patients Patients aged 18-100+ years; depression diagnosed 6/12 or more; primary care only; taking antidepressants
Data Analysis • Questionnaires: • QSR N6 • Qualitative data analysis computer software tool • Interviews: • Framework • Thematic approach • Data indexed and charted according to key issues and themes • NVivo
Findings • A trajectory towards madness? • Depression - A chemical imbalance? • Antidepressants – friend or foe? • Self • Stopping antidepressants • Recovery
Conclusions • Multiple insights • Clinician-researcher role • Interview process
Thank You Email p.louch@ucl.ac.uk Website www.depression-primarycare.co.uk