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“You feel like your whole world is caving in”: A qualitative study of primary care patients’conceptualisations of emotional distress

“You feel like your whole world is caving in”: A qualitative study of primary care patients’conceptualisations of emotional distress
“You feel like your whole world is caving in”: A qualitative study of primary care patients’conceptualisations of emotional distress
General Practitioners (GPs) are tasked with determining the nature of patients’ emotional distress and providing appropriate care. For patients whose symptoms appear to fall near the ‘boundaries’ of psychiatric disorder, this can be difficult with important implications for treatment. There is a lack of qualitative research amongst patients with symptoms severe enough to warrant consultation, but where GPs have refrained from diagnosis. We aimed to explore how patients in this potentially large group conceptualise their symptoms, and consequently investigate lay understandings of complex distinctions between emotional distress and psychiatric disorder. Interviews were conducted with 20 primary care patients whom GPs had identified as experiencing emotional distress, but had not diagnosed with major depressive disorder. Participants described severe emotional experiences with substantial impact on their lives. The term ‘depression’ was used in many different ways; however, despite severity they often considered their emotional experience to be different to their perceived notions of ‘actual’ depression or mental illness. Where anxiety was mentioned, use appeared to refer to an underlying generalised state. Participants drew on complex, sometimes fluid, and often theoretically coherent conceptualisations of their emotional distress, as related to, but distinct from, mental disorder. These conceptualisations differ from those frequently drawn on in research and treatment guidelines, compounding the difficulty for GPs. Developing models of psychological symptoms that draw on patient experience and integrate psychological/psychiatric theory may help patients understand the nature of their experience, and critically, provide the basis for a broader range of primary care interventions
1363-4593
1-37
Geraghty, Adam W.A.
2c6549fe-9868-4806-b65a-21881c1930af
Santer, Miriam
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Williams, Sam
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Mcsharry, Jennifer
48955433-0a4a-4c1c-84e6-12551df4c951
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Muñoz, Ricard F.
c7c16099-97ad-4928-9349-68b62e935b81
Kendrick, Tony
c697a72c-c698-469d-8ac2-f00df40583e5
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Geraghty, Adam W.A.
2c6549fe-9868-4806-b65a-21881c1930af
Santer, Miriam
3ce7e832-31eb-4d27-9876-3a1cd7f381dc
Williams, Sam
7cec7c3e-7247-473e-8121-f26b625893e1
Mcsharry, Jennifer
48955433-0a4a-4c1c-84e6-12551df4c951
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Muñoz, Ricard F.
c7c16099-97ad-4928-9349-68b62e935b81
Kendrick, Tony
c697a72c-c698-469d-8ac2-f00df40583e5
Moore, Michael
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Geraghty, Adam W.A., Santer, Miriam, Williams, Sam, Mcsharry, Jennifer, Little, Paul, Muñoz, Ricard F., Kendrick, Tony and Moore, Michael (2017) “You feel like your whole world is caving in”: A qualitative study of primary care patients’conceptualisations of emotional distress. Health, 1-37.

Record type: Article

Abstract

General Practitioners (GPs) are tasked with determining the nature of patients’ emotional distress and providing appropriate care. For patients whose symptoms appear to fall near the ‘boundaries’ of psychiatric disorder, this can be difficult with important implications for treatment. There is a lack of qualitative research amongst patients with symptoms severe enough to warrant consultation, but where GPs have refrained from diagnosis. We aimed to explore how patients in this potentially large group conceptualise their symptoms, and consequently investigate lay understandings of complex distinctions between emotional distress and psychiatric disorder. Interviews were conducted with 20 primary care patients whom GPs had identified as experiencing emotional distress, but had not diagnosed with major depressive disorder. Participants described severe emotional experiences with substantial impact on their lives. The term ‘depression’ was used in many different ways; however, despite severity they often considered their emotional experience to be different to their perceived notions of ‘actual’ depression or mental illness. Where anxiety was mentioned, use appeared to refer to an underlying generalised state. Participants drew on complex, sometimes fluid, and often theoretically coherent conceptualisations of their emotional distress, as related to, but distinct from, mental disorder. These conceptualisations differ from those frequently drawn on in research and treatment guidelines, compounding the difficulty for GPs. Developing models of psychological symptoms that draw on patient experience and integrate psychological/psychiatric theory may help patients understand the nature of their experience, and critically, provide the basis for a broader range of primary care interventions

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Distress qual paper - in press - final accepted version.pdf - Accepted Manuscript
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More information

Accepted/In Press date: 17 June 2016
e-pub ahead of print date: 1 October 2016
Published date: 1 May 2017
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 401188
URI: http://eprints.soton.ac.uk/id/eprint/401188
ISSN: 1363-4593
PURE UUID: 2731c933-59ef-45a0-ae9b-967c8355cba0
ORCID for Adam W.A. Geraghty: ORCID iD orcid.org/0000-0001-7984-8351
ORCID for Miriam Santer: ORCID iD orcid.org/0000-0001-7264-5260
ORCID for Sam Williams: ORCID iD orcid.org/0000-0001-9505-6485
ORCID for Paul Little: ORCID iD orcid.org/0000-0003-3664-1873
ORCID for Tony Kendrick: ORCID iD orcid.org/0000-0003-1618-9381
ORCID for Michael Moore: ORCID iD orcid.org/0000-0002-5127-4509

Catalogue record

Date deposited: 10 Oct 2016 09:07
Last modified: 12 Jul 2024 04:04

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Contributors

Author: Miriam Santer ORCID iD
Author: Sam Williams ORCID iD
Author: Jennifer Mcsharry
Author: Paul Little ORCID iD
Author: Ricard F. Muñoz
Author: Tony Kendrick ORCID iD
Author: Michael Moore ORCID iD

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