Evid Based Nurs 8:93 doi:10.1136/ebn.8.3.93
  • Qualitative

Adolescents’ conceptualisations of depression (a helpful label, chronic medical problem, or personality characteristic) affected their attitudes and decisions about treatment

 Q How do adolescents with depression experience and understand the disease? How do they interpret the medical diagnosis?


Modified grounded theory.


Oregon and Washington state, USA.


A purposive sample of 15 adolescents 14–19 years of age (mean age 16 y, 53% girls) who were diagnosed with depression was recruited from a non-profit, group model, health maintenance organisation. Most were no longer receiving treatment.


13 adolescents participated in individual 90 minute interviews; 2 were interviewed by telephone. Questions focused on reasons for depression and the process of examining their feelings and determining whether they needed professional help. Interviews were tape recorded, and field notes documented additional information such as non-verbal communication. Tapes and field notes were transcribed verbatim, and data were analysed using constant comparison.


A theoretical, chronological scheme was developed based on participants’ descriptions of their experiences. (1) Growth of distress. Many teens wished to return to the time before they became depressed. They described the slow growth of distress over months or years, from imperceptible to incapacitating. Often, a specific event (eg, parental divorce or death of a relative or friend) triggered the growth of distress …

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