title: Caregivers' experiences with major depression concealed by physical illness in patients recruited from central Ugandan Primary Health Care Centers.
abstract: In this article, we present caregivers' grapples with major depression seen among their physically ill patients. A thematic analysis of 29 in-depth caregiver interviews identified four themes: (a) caregivers' perceptions of depression, (b) barriers to caregivers' focus on depression, (c) resources and opportunities for managing depression, and (d) caregivers' perspectives on consequences of depression. Patients' physical illnesses concealed depressive episodes. Caregivers could not apply the label of "depression" but enumerated its indicative features. Stigmatization of depression, common with other mental illnesses and poverty, undermined caregiving. Vital caregiving resources included caregivers' willingness to meet patients' basic needs, facilitating patients' access to health care, informal counseling of patients, and ensuring patients' spiritual nourishment. Caregivers' management of depression in physically ill patients was expensive, but they coped; however, caregiving was burdensome. Ongoing support should be given not only to patients but caregivers, as well. To provide appropriate care, caregivers deserve sensitization about depression in the context of physical illness.
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Makerere University, Kampala, Uganda.
authors.forename: Wilson Winstons
authors.initials: WW
authors.lastname: Muhwezi
authors.forename: Elialilia Sarikiaeli
authors.initials: ES
authors.lastname: Okello
authors.forename: Stella
authors.initials: S
authors.lastname: Neema
authors.forename: Seggane
authors.initials: S
authors.lastname: Musisi
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D017028:Caregivers; D003151:Community Health Centers; D003865:Major Depressive Disorder / Q000208:ethnology / Q000451:nursing / Q000523:psychology; D004194:Disease / Q000523:psychology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010361:Patients / Q000523:psychology*; D011203:Poverty; D011287:Prejudice; D011320:Primary Health Care; D014454:Uganda