Understandings of Depression.
An Investigation of Understandings among General Practitioners and Psychiatrists

Today’s treatment of depression is not satisfactory, mostly because the patient is not guaranteed qualified and cohesive treatment. Research suggests that cohesion between general practice and psychiatry has a positive impact on patients with depression, leading to reduced illness and mortality.

The overall objective of the “Understandings of Depression” project is to map general practitioners’ and psychiatrists’ understandings of depression and patients with depression. The investigation will contribute to illuminating barriers and opportunities for aligning patients’ treatment.

The project was initiated in 2011 by Annette Sofie Davidsen (The Research Unit for General Practice) and Christina Fogtmann Fosgerau. It is based on video recordings of consultations between patients diagnosed with depression, and general practitioners and psychiatrists, respectively, just as interviews with all physicians from the consultations were conducted.

The project is framed within the areas of phenomenology and mentalisation. The interactional analyses between physicians and patients in consultations are based primarily on Conversation Analysis and Systemic Functional Linguistics. Analyses of the interviews are conducted using IPA (Interpretative Phenomenological Analysis). The interactional analyses focus on aspects such as the physicians’ attention to the patients’ emotions and general life circumstances, the physicians ’ ways of expressing understanding for the patients, as well as the negotiation of medical antidepressant treatment. The studies of the interviews answer questions about the physicians’ conceptualisation of depression and of the diagnosis.

PhD fellow Hanne Sæderup Pedersen joined the project in 2012 and is examining the physicians’ representations of patients in the interview data, more specifically how the concept of speech and thought presentation is employed to construct patient identities in a range of narrative genres. This representational perspective – how the physicians talk about their patients – can also be seen as supplementing the investigations of the physicians’ interaction with patients in consultations. Read description of the PhD-project here.