Self-management strategies and care needs of patients with persistent depressive disorder and their informal caregivers: a multi-perspectives qualitative interview study

IntroductionWhen patients with persistent depressive disorder (PDD) respond insufficiently to available evidence-based treatments, depression treatment guidelines recommend psychiatric rehabilitation through self-management. Preferably, the intervention should involve the patient’s informal caregive...

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Main Authors: Ericka C. Solis, Ingrid V. E. Carlier, Noëlle G. A. Kamminga, Albert M. van Hemert
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Psychiatry
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1505396/full
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author Ericka C. Solis
Ingrid V. E. Carlier
Noëlle G. A. Kamminga
Noëlle G. A. Kamminga
Albert M. van Hemert
author_facet Ericka C. Solis
Ingrid V. E. Carlier
Noëlle G. A. Kamminga
Noëlle G. A. Kamminga
Albert M. van Hemert
author_sort Ericka C. Solis
collection DOAJ
description IntroductionWhen patients with persistent depressive disorder (PDD) respond insufficiently to available evidence-based treatments, depression treatment guidelines recommend psychiatric rehabilitation through self-management. Preferably, the intervention should involve the patient’s informal caregiver.MethodsTo gain insight into the healthcare needs of PDD patients and their caregivers and to facilitate the implementation of a self-management program, we conducted individual semi-structured interviews with 28 PDD patients and 9 informal caregivers regarding their self-management/coping and needs. Transcripts were analyzed with Grounded Theory using three sensitizing concepts (PDD experience, self-management/coping, needs).ResultsPatients had 9 main themes and caregivers had 11 main themes. Patients and caregivers shared 9 main themes, pertaining to powerlessness, patients’ identity changes, shame/stigma, relationship dissatisfaction, family suffering, self-management attitudes, self-management strategies, coping support, and coping complications. While self-management attitudes of patients were mixed, those of caregivers were positive. Care needs of both groups centered on psychoeducation and communication skills development. Caregivers reported urgently needing support in dealing with patients’ suicidal behavior.DiscussionOur findings underscore the profound burden of PDD on both patients and their informal caregivers. We strongly recommend that healthcare professionals encourage and facilitate the development of self-management in depressed patients early in the treatment process and involve informal caregivers, particularly within suicide prevention strategies.Clinical Trial Registrationhttps://onderzoekmetmensen.nl/en/trial/55681, Netherlands Trial Register Identifier NL5818.
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spelling doaj-art-49ee905d9f074c079f3455747f0b09cc2025-08-20T03:21:43ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-06-011610.3389/fpsyt.2025.15053961505396Self-management strategies and care needs of patients with persistent depressive disorder and their informal caregivers: a multi-perspectives qualitative interview studyEricka C. Solis0Ingrid V. E. Carlier1Noëlle G. A. Kamminga2Noëlle G. A. Kamminga3Albert M. van Hemert4Department of Psychiatry, Leiden University Medical Center, Leiden, NetherlandsDepartment of Psychiatry, Leiden University Medical Center, Leiden, NetherlandsDepartment of Psychiatry and Medical Psychology, Maastricht University Medical Center, Maastricht, NetherlandsFaculty of Health, Medicine and Life Sciences (MHeNs), Maastricht University, Maastricht, NetherlandsDepartment of Psychiatry, Leiden University Medical Center, Leiden, NetherlandsIntroductionWhen patients with persistent depressive disorder (PDD) respond insufficiently to available evidence-based treatments, depression treatment guidelines recommend psychiatric rehabilitation through self-management. Preferably, the intervention should involve the patient’s informal caregiver.MethodsTo gain insight into the healthcare needs of PDD patients and their caregivers and to facilitate the implementation of a self-management program, we conducted individual semi-structured interviews with 28 PDD patients and 9 informal caregivers regarding their self-management/coping and needs. Transcripts were analyzed with Grounded Theory using three sensitizing concepts (PDD experience, self-management/coping, needs).ResultsPatients had 9 main themes and caregivers had 11 main themes. Patients and caregivers shared 9 main themes, pertaining to powerlessness, patients’ identity changes, shame/stigma, relationship dissatisfaction, family suffering, self-management attitudes, self-management strategies, coping support, and coping complications. While self-management attitudes of patients were mixed, those of caregivers were positive. Care needs of both groups centered on psychoeducation and communication skills development. Caregivers reported urgently needing support in dealing with patients’ suicidal behavior.DiscussionOur findings underscore the profound burden of PDD on both patients and their informal caregivers. We strongly recommend that healthcare professionals encourage and facilitate the development of self-management in depressed patients early in the treatment process and involve informal caregivers, particularly within suicide prevention strategies.Clinical Trial Registrationhttps://onderzoekmetmensen.nl/en/trial/55681, Netherlands Trial Register Identifier NL5818.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1505396/fullself-managementchronic depressionpersistent depressive disorderqualitative studycare needscarer
spellingShingle Ericka C. Solis
Ingrid V. E. Carlier
Noëlle G. A. Kamminga
Noëlle G. A. Kamminga
Albert M. van Hemert
Self-management strategies and care needs of patients with persistent depressive disorder and their informal caregivers: a multi-perspectives qualitative interview study
Frontiers in Psychiatry
self-management
chronic depression
persistent depressive disorder
qualitative study
care needs
carer
title Self-management strategies and care needs of patients with persistent depressive disorder and their informal caregivers: a multi-perspectives qualitative interview study
title_full Self-management strategies and care needs of patients with persistent depressive disorder and their informal caregivers: a multi-perspectives qualitative interview study
title_fullStr Self-management strategies and care needs of patients with persistent depressive disorder and their informal caregivers: a multi-perspectives qualitative interview study
title_full_unstemmed Self-management strategies and care needs of patients with persistent depressive disorder and their informal caregivers: a multi-perspectives qualitative interview study
title_short Self-management strategies and care needs of patients with persistent depressive disorder and their informal caregivers: a multi-perspectives qualitative interview study
title_sort self management strategies and care needs of patients with persistent depressive disorder and their informal caregivers a multi perspectives qualitative interview study
topic self-management
chronic depression
persistent depressive disorder
qualitative study
care needs
carer
url https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1505396/full
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