On taking up space: a qualitative inquiry of depression in older adults with cancer

ObjectiveTo identify the phenomenology of depression in older adults with cancer (OACs) in order to improve the accuracy of depression screening for this population.MethodInclusion criteria were: >= 70 years old, history of cancer, no cognitive impairment or severe psychopathology. Participants completed a demographic questionnaire, a diagnostic interview, and a qualitative interview. Using a Thematic Content Analysis framework, critical themes, passages, and phrases used by patients to describe their perceptions of depression and how it is experienced were identified. Particular attention was paid to divergences between depressed and non-depressed participants.ResultsAmong 26 OACs (13 depressed, 13 non-depressed), qualitative analyses revealed four major themes indicative of depression (i.e. anhedonia, reduction in social relationships/loneliness, lack of meaning and purpose, lack of usefulness/feeling like a burden) and four minor themes (i.e. attitude towards treatment, mood, regret/guilt, physical symptoms/limitations). Themes of adaptation and acceptance of symptoms also emerged.ConclusionsOf the eight themes identified, only two overlap with DSM criteria. This supports the need to develop assessment methods of depression in OACs that are less reliant on DSM criteria and distinct from existing measures. This may improve the ability to identify depression in this population.

Automated summary

The objective of this study was to identify the phenomenology of depression in older adults with cancer (OACs) in order to improve the accuracy of depression screening for this population. Qualitative analyses revealed several major and minor themes related to depression, as well as themes of adaptation and acceptance of symptoms. The findings suggest the need for assessment methods that are distinct from existing measures to better identify depression in OACs.