Abstract
Objective
To identify the phenomenology of depression in older adults with cancer (OACs) in order to improve the accuracy of depression screening for this population.
Method
Inclusion 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.
Results
Among 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.
Conclusions
Of 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.
Acknowledgements
The authors would like to acknowledge Arti Hurria and Jimmie Holland who were pioneers in developing this line of work and are missed dearly. We also thank our patient participants for their thoughtfulness and generosity contributing to this study.
Disclosure statement
No potential conflict of interest was reported by the authors.