Experiences of Seeking and Accessing Medical Care Among Persons with Major Depression: A Qualitative Descriptive Study of Persons with Depression in China

Overview

Journal Front Psychiatry

Specialty Psychiatry

Date 2023 Feb 27

PMID 36846228

Authors

Yan Hua Zhou

Doris Leung

Jian Kui Lin

Li Chan Hu

Xiao Yang Lin

Xuelin Zhang

Yim Wah Mak

Affiliations

Soon will be listed here.

Abstract

Introduction: A large number of people in China are affected by depression, yet tend to delay seeking treatment. This study aims to explore persons living with depression and their journey of diagnoses and seeking professional medical help in China.

Methods: Semi-structured interviews were conducted with 20 persons who visiting physicians to be diagnosed and receive professional help from a large mental health center in Guangzhou, Guangdong province, China. Individual interviews were conducted and data were analyzed using content analysis.

Results: Three themes were identified from the findings: (1) "noticed something was wrong"; (2) negotiated decisions with their own narratives and the personal suggestions of others; and (3) gave new meaning to their experiences of depression, whereby they sought medical treatment.

Discussion: The findings of the study indicated that the impact of progressive depressive symptoms on the participants' daily lives was a strong motivation for them to seek professional help. The obligation to care for and support their family prevented them from initially disclosing their depressive symptoms to family members, but eventually prompted them to seek professional help and persist in follow-up treatment. Some participants experienced unexpected benefits (e.g., relief at no longer feeling "alone") during their first visit to the hospital for depression or when they were diagnosed with depression. The results suggest a need to continue to actively screen for depression and provide more public education to prevent negative assumptions and reduce public and personal stigmatization of those with mental health problems.

Citing Articles

Commentary: Predictors of professional help-seeking intention toward depression among community-dwelling populations: a structural equation modeling analysis.

Fung K, Kim S Front Psychiatry. 2024; 15:1363160.

PMID: 38559398 PMC: 10978789. DOI: 10.3389/fpsyt.2024.1363160.

References

Elo S, Kyngas H . The qualitative content analysis process. J Adv Nurs. 2008; 62(1):107-15. DOI: 10.1111/j.1365-2648.2007.04569.x. View

Jiang Y, Bogner H, Wang X, Wang J, Zhu T, Conwell Y . Primary care patient beliefs and help-seeking preferences regarding depression in China. Psychiatry Res. 2018; 269:1-8. DOI: 10.1016/j.psychres.2018.08.031. View

Ahmad F, Maule C, Wang J, Fung W . Symptoms and Experience of Depression Among Chinese Communities in the West: A Scoping Review. Harv Rev Psychiatry. 2018; 26(6):340-351. DOI: 10.1097/HRP.0000000000000202. View

Mouchet-Mages S, Bayle F . Sadness as an integral part of depression. Dialogues Clin Neurosci. 2008; 10(3):321-7. PMC: 3181878. View

Donohue J, Pincus H . Reducing the societal burden of depression: a review of economic costs, quality of care and effects of treatment. Pharmacoeconomics. 2006; 25(1):7-24. DOI: 10.2165/00019053-200725010-00003. View

Hasin D, Sarvet A, Meyers J, Saha T, Ruan W, Stohl M . Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States. JAMA Psychiatry. 2018; 75(4):336-346. PMC: 5875313. DOI: 10.1001/jamapsychiatry.2017.4602. View

Bukh J, Bock C, Vinberg M, Kessing L . The effect of prolonged duration of untreated depression on antidepressant treatment outcome. J Affect Disord. 2012; 145(1):42-8. DOI: 10.1016/j.jad.2012.07.008. View

Gulliver A, Griffiths K, Christensen H . Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry. 2011; 10:113. PMC: 3022639. DOI: 10.1186/1471-244X-10-113. View

Oguchi Y, Nakagawa A, Sado M, Mitsuda D, Nakagawa Y, Kato N . Potential predictors of delay in initial treatment contact after the first onset of depression in Japan: a clinical sample study. Int J Ment Health Syst. 2014; 8(1):50. PMC: 4271502. DOI: 10.1186/1752-4458-8-50. View

10.

Stanhope V . Culture, control, and family involvement: a comparison of psychosocial rehabilitation in India and the United States. Psychiatr Rehabil J. 2002; 25(3):273-80. DOI: 10.1037/h0095015. View

11.

Barney L, Griffiths K, Jorm A, Christensen H . Stigma about depression and its impact on help-seeking intentions. Aust N Z J Psychiatry. 2006; 40(1):51-4. DOI: 10.1080/j.1440-1614.2006.01741.x. View

12.

Okello E, Neema S . Explanatory models and help-seeking behavior: Pathways to psychiatric care among patients admitted for depression in Mulago hospital, Kampala, Uganda. Qual Health Res. 2006; 17(1):14-25. DOI: 10.1177/1049732306296433. View

13.

Doblyte S, Jimenez-Mejias E . Understanding Help-Seeking Behavior in Depression: A Qualitative Synthesis of Patients' Experiences. Qual Health Res. 2016; 27(1):100-113. DOI: 10.1177/1049732316681282. View

14.

Uebelacker L, Marootian B, Pirraglia P, Primack J, Tigue P, Haggarty R . Barriers and facilitators of treatment for depression in a latino community: a focus group study. Community Ment Health J. 2011; 48(1):114-26. DOI: 10.1007/s10597-011-9388-7. View

15.

Kim H, Sefcik J, Bradway C . Characteristics of Qualitative Descriptive Studies: A Systematic Review. Res Nurs Health. 2016; 40(1):23-42. PMC: 5225027. DOI: 10.1002/nur.21768. View

16.

Lienemann B, Siegel J, Crano W . Persuading people with depression to seek help: respect the boomerang. Health Commun. 2012; 28(7):718-28. DOI: 10.1080/10410236.2012.712091. View

17.

Simon G, Fleck M, Lucas R, Bushnell D . Prevalence and predictors of depression treatment in an international primary care study. Am J Psychiatry. 2004; 161(9):1626-34. DOI: 10.1176/appi.ajp.161.9.1626. View

18.

Ben-David S, Cole A, Brucato G, Girgis R, Munson M . Mental health service use decision-making among young adults at clinical high risk for developing psychosis. Early Interv Psychiatry. 2018; 13(5):1050-1055. DOI: 10.1111/eip.12725. View

19.

Wang P, Angermeyer M, Borges G, Bruffaerts R, Chiu W, de Girolamo G . Delay and failure in treatment seeking after first onset of mental disorders in the World Health Organization's World Mental Health Survey Initiative. World Psychiatry. 2008; 6(3):177-85. PMC: 2174579. View

20.

Harvey S, Glozier N, Henderson M, Allaway S, Litchfield P, Holland-Elliott K . Depression and work performance: an ecological study using web-based screening. Occup Med (Lond). 2011; 61(3):209-11. DOI: 10.1093/occmed/kqr020. View