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      Being stuck in a vice: The process of coping with severe depression in late life

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          Abstract

          Articles describing older persons’ experiences of coping with severe depression are, to our knowledge, lacking. This article is methodologically grounded in phenomenological hermeneutics, inspired by Paul Ricoeur, and applies a descriptive design with in-depth interviews for producing the data. We included 18 older persons, 13 women and 5 men, with a mean age of 77.9 years, depressed to a severe or moderate degree, 1–2 weeks after admission to a hospital for treatment of depression. We found the metaphor “being in a vice” to capture the essence of meaning from the participants’ stories, and can be understood as being stuck in an immensely painful existence entirely dominated by depression in late life. This is the first article where coping in older men and women experiencing the most severe phase of depression is explored.

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          InterViews : An Introduction to Qualitative Research Interviewing

          Interviewing is an essential tool in qualitative research and this introduction to interviewing outlines both the theoretical underpinnings and the practical aspects of the process. After examining the role of the interview in the research process, Steinar Kvale considers some of the key philosophical issues relating to interviewing: the interview as conversation, hermeneutics, phenomenology, concerns about ethics as well as validity, and postmodernism. Having established this framework, the author then analyzes the seven stages of the interview process - from designing a study to writing it up.
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            Just listening: Narrative and deep illness.

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              Early and late onset depression in old age: different aetiologies, same phenomenology.

              Phenomenological differences between older patients with early onset (EO; onset of first major depressive episode before 60 years) and late onset (LO) depression have been inconsistent but, if real, may reflect differences in aetiology. We aimed to compare aetiological factors, phenomenology and cognitive function in older patients with depression by age of onset. Subjects were all patients > or =60 years old (n=73) from 407 consecutive attenders to a Mood Disorders Unit, diagnosed with DSM-III-R Major Depressive Episode, at or close to the nadir of their episode. Putative risk factors were assessed by structured interview. Psychological morbidity and depressive symptoms were assessed by the 21-item Hamilton Rating Scale for Depression, CORE rating of psychomotor disturbance, Newcastle Endogeneity Scale, Zung Depression Scale and General Health Questionnaire. Cognition was assessed by tests of memory, attention, executive function and motor speed. Personality abnormalities, a family history of psychiatric illness and dysfunctional past maternal relationships were significantly more common in EO depression. The two age of onset groups were essentially similar in terms of depressive sub-type and severity, phenomenology, history of previous episode, and in neuropsychological performance. Use of self-report data, moderate sample size, sample not age-matched, tertiary referral patients. EO and LO depression are similar phenotypically, but differ aetiologically. The pursuit of mechanisms which predispose depressive episodes may be heuristically more valuable than further investigation of individual depressive features in distinguishing early from late onset depression.
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                Author and article information

                Contributors
                Role: Gerontopsychologist
                Role: Professor
                Role: Professor
                Role: Professor
                Role: Postdoctor, Senior Researcher
                Journal
                Int J Qual Stud Health Well-being
                Int J Qual Stud Health Well-being
                QHW
                International Journal of Qualitative Studies on Health and Well-being
                Co-Action Publishing
                1748-2623
                1748-2631
                26 June 2015
                2015
                : 10
                : 10.3402/qhw.v10.27187
                Affiliations
                [1 ]Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
                [2 ]Department for Mental Health Research and Development, Division for Mental health and addiction, Vestre Viken Hospital Trust, Lier, Norway
                [3 ]Faculty of Medicine, University of Oslo, Oslo, Norway
                [4 ]Research Centre of Old Age Psychiatry, Innlandet Hospital Trust, Ottestad, Norway
                [5 ]Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
                [6 ]St Olav's University Hospital, Trondheim, Norway
                Author notes
                [* ]Correspondence: G. H. Bjørkløf, Ageing and Health, Norwegian Advisory Unit on Ageing and Health, Postbox 2136, NO-3103 Tønsberg, Norway. E-mail: Guro.Bjorklof@ 123456aldringoghelse.no
                Article
                27187
                10.3402/qhw.v10.27187
                4483368
                26119368
                4b73b8e6-6ad2-4996-bf01-2484c9ab35e4
                © 2015 G. H. Bjørkløf et al.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license.

                History
                : 10 May 2015
                Categories
                Empirical Study

                Health & Social care
                lived experience,depression,older people,coping
                Health & Social care
                lived experience, depression, older people, coping

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