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7 Depression Research Paper Topic Ideas

In psychology classes, it's common for students to write a depression research paper. Researching depression may be beneficial if you have a personal interest in this topic and want to learn more, or if you're simply passionate about this mental health issue. However, since depression is a very complex subject, it offers many possible topics to focus on, which may leave you wondering where to begin.

If this is how you feel, here are a few research titles about depression to help inspire your topic choice. You can use these suggestions as actual research titles about depression, or you can use them to lead you to other more in-depth topics that you can look into further for your depression research paper.

What Is Depression?

Everyone experiences times when they feel a little bit blue or sad. This is a normal part of being human. Depression, however, is a medical condition that is quite different from everyday moodiness.

Your depression research paper may explore the basics, or it might delve deeper into the definition of clinical depression or the difference between clinical depression and sadness .

What Research Says About the Psychology of Depression

Studies suggest that there are biological, psychological, and social aspects to depression, giving you many different areas to consider for your research title about depression.

Types of Depression

There are several different types of depression that are dependent on how an individual's depression symptoms manifest themselves. Depression symptoms may vary in severity or in what is causing them. For instance, major depressive disorder (MDD) may have no identifiable cause, while postpartum depression is typically linked to pregnancy and childbirth.

Depressive symptoms may also be part of an illness called bipolar disorder. This includes fluctuations between depressive episodes and a state of extreme elation called mania. Bipolar disorder is a topic that offers many research opportunities, from its definition and its causes to associated risks, symptoms, and treatment.

Causes of Depression

The possible causes of depression are many and not yet well understood. However, it most likely results from an interplay of genetic vulnerability and environmental factors. Your depression research paper could explore one or more of these causes and reference the latest research on the topic.

For instance, how does an imbalance in brain chemistry or poor nutrition relate to depression? Is there a relationship between the stressful, busier lives of today's society and the rise of depression? How can grief or a major medical condition lead to overwhelming sadness and depression?

Who Is at Risk for Depression?

This is a good research question about depression as certain risk factors may make a person more prone to developing this mental health condition, such as a family history of depression, adverse childhood experiences, stress , illness, and gender . This is not a complete list of all risk factors, however, it's a good place to start.

The growing rate of depression in children, teenagers, and young adults is an interesting subtopic you can focus on as well. Whether you dive into the reasons behind the increase in rates of depression or discuss the treatment options that are safe for young people, there is a lot of research available in this area and many unanswered questions to consider.

Depression Signs and Symptoms

The signs of depression are those outward manifestations of the illness that a doctor can observe when they examine a patient. For example, a lack of emotional responsiveness is a visible sign. On the other hand, symptoms are subjective things about the illness that only the patient can observe, such as feelings of guilt or sadness.

An illness such as depression is often invisible to the outside observer. That is why it is very important for patients to make an accurate accounting of all of their symptoms so their doctor can diagnose them properly. In your depression research paper, you may explore these "invisible" symptoms of depression in adults or explore how depression symptoms can be different in children .

How Is Depression Diagnosed?

This is another good depression research topic because, in some ways, the diagnosis of depression is more of an art than a science. Doctors must generally rely upon the patient's set of symptoms and what they can observe about them during their examination to make a diagnosis.

While there are certain laboratory tests that can be performed to rule out other medical illnesses as a cause of depression, there is not yet a definitive test for depression itself.

If you'd like to pursue this topic, you may want to start with the Diagnostic and Statistical Manual of Mental Disorders (DSM). The fifth edition, known as DSM-5, offers a very detailed explanation that guides doctors to a diagnosis. You can also compare the current model of diagnosing depression to historical methods of diagnosis—how have these updates improved the way depression is treated?

Treatment Options for Depression

The first choice for depression treatment is generally an antidepressant medication. Selective serotonin reuptake inhibitors (SSRIs) are the most popular choice because they can be quite effective and tend to have fewer side effects than other types of antidepressants.

Psychotherapy, or talk therapy, is another effective and common choice. It is especially efficacious when combined with antidepressant therapy. Certain other treatments, such as electroconvulsive therapy (ECT) or vagus nerve stimulation (VNS), are most commonly used for patients who do not respond to more common forms of treatment.

Focusing on one of these treatments is an option for your depression research paper. Comparing and contrasting several different types of treatment can also make a good research title about depression.

A Word From Verywell

The topic of depression really can take you down many different roads. When making your final decision on which to pursue in your depression research paper, it's often helpful to start by listing a few areas that pique your interest.

From there, consider doing a little preliminary research. You may come across something that grabs your attention like a new study, a controversial topic you didn't know about, or something that hits a personal note. This will help you narrow your focus, giving you your final research title about depression.

Remes O, Mendes JF, Templeton P. Biological, psychological, and social determinants of depression: A review of recent literature . Brain Sci . 2021;11(12):1633. doi:10.3390/brainsci11121633

National Institute of Mental Health. Depression .

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition . American Psychiatric Association.

National Institute of Mental Health. Mental health medications .

Ferri, F. F. (2019). Ferri's Clinical Advisor 2020 E-Book: 5 Books in 1 . Netherlands: Elsevier Health Sciences.

By Nancy Schimelpfening Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be.

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233 Depression Research Topics & Essay Titles + Examples

If you’re looking for a good depression research title, you’re at the right place! StudyCorgi has prepared a list of titles for depression essays and research questions that you can use for your presentation, persuasive paper, and other writing assignments. Read on to find your perfect research title about depression!

🙁 TOP 7 Depression Title Ideas

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Teenage Depression: Causes and Symptoms
Depression: Case Conceptualization and Treatment Planning
Depression and Solutions in Psychiatry
Adolescent Mental Health: Depression
Depression and Depressive Disorders
Depression: Psychoeducational Intervention
Depression: Comprehensive Treatment Plan
Mitigating Postnatal Depression in New Mothers: A Recreational Program Plan Post-natal depression is a popular form of depression in women. This paper presents an activity plan for the use of leisure as a therapeutic response to post-natal depression.
Depression in Hispanic Culture There are different ways in which culture or ethnicity can impact the treatment of the development of mental health disorders.
Depression as It Relates to Obesity This paper will argue that there is a positive correlation between depression and obesity. The paper will make use of authoritative sources to reinforce this assertion.
Mental Health Association of Depression and Alzheimer’s in the Elderly Depression can be a part of Alzheimer’s disease. Elderly people may have episodes of depression, but these episodes cannot be always linked to Alzheimer’s disease.
Social Media as a Cause of Anxiety and Depression Anxiety and depression are considerable problems for world society. Numerous studies have linked high social media use with high levels of anxiety and depression.
The Concept of Postpartum Depression Postpartum depression is a common condition involving psychological, emotional, social, and physical changes that many new mothers experience immediately after giving birth.
Major Depression’ Symptoms and Treatment – Psychology A continuous sense of tiredness, unhappiness, and hopelessness are key signs of clinical or major depression. Such mood changes alter the daily life programs of an individual for sometimes.
African American Children Suffering From Anxiety and Depression Depression and anxiety are common among African American children and adolescents, and they face significant barriers to receiving care and treatment.
CBT and Depression The paper discusses the short-term and long-term application of cognitive behavioral therapy for the purpose of relapse prevention in patients with major depressive disorder.
The Rise of Depression in the Era of the Internet Understanding how the Internet affects human lives is essential in ascertaining the reasons for the growing loneliness in the intrinsically connected world.
Geriatric Depression Scale, Clock Drawing Test and Mini-Mental Status Examination Depression is a common condition among geriatric patients. Around 5 million older adults in the US experience significant morbidity from depression.
History and Treatment of Depression Depression is currently one of the most common medical conditions among the adult population in the US. The paper aims to investigate the history and treatment of depression.
Self-Esteem and Depression in Quantitative Research The topic that has been proposed for quantitative research pertains to the problem of the relationship between self-esteem and depression.
Impact of Depression on a Family The article makes a very powerful argument about the effects of depression on the relatives of the patient by identifying the major factors that put the family into a challenging position.
The Causes of Depression and How to Overcome It In this self-reflection essay, the author describes the causes of his depression and the steps he is taking to overcome it.
Application of Analysis of Variance in the Analysis of HIV/AIDS-Related Depression Cases Analysis of variance (ANOVA) is a commonly used approach in the testing of the equality of various means using variance.
Diagnosing and Managing Headaches and Weight Gain in a 21-Year-Old Young people are busy at studies or at work and do not pay much attention to primary symptoms unless they influence the quality of life.
Depression in Older Adults Depression is one of the most common mental illnesses in the world. Evidence-based holistic intervention would provide more effective treatment for elderly patients with depression.
Guideline on Antidepressants’ Use During Depression The paper states that in cases when antidepressants are necessary, it is vital to follow the algorithm and ensure the most effective drug is selected.
Postnatal Depression: Prevention and Treatment This presentation will cover the reflection on the health promotion aimed at postnatal depression prevention and treatment in Mental Health UK.
Treating Psychological Disorders: Depression The best psychological treatment for clinical depression is Cognitive Behavioral Therapy and Psychodynamic Approach, which focus on altering negative thoughts.
Social Media as a Tool for Depression Detection This article would make a source for research on the link between social media and depression because it suggests an adequate technological tool for detecting depressive signs.
Anxiety, Depression, and Post-Traumatic Stress Disorder Currently, many people experience anxiety, depression, and post-traumatic stress disorder that affect their general health.
Women’s Mental Health Disorder: Major Depression The mental health disorder paper aims to explore major depression, its symptoms, assessment, and intervention strategies appropriate for women.
Depression in Young Adults: Annotated Bibliography The purpose of this study was to discover sociodemographic and health traits related to depression sufferers’ usage of various mental health services.
Depression in Middle-Aged African Women The research study investigates depression in middle-aged African women because the mental health of the population is a serious concern of the modern healthcare sector.
Detecting Depression in Young Adults: Literature Review The paper shows a need for early identification of depression symptoms in primary care practice. PHQ-2 and PHQ-9 are useful tools for portraying symptoms.
Predicting Barriers to Treatment for Depression Mental health issues such as depression and drug abuse are the most frequent among teenagers and young adults. In this age range, both disorders tend to co-occur.
What Are the Characteristics and Causes of Depression?
Why Are Athletes Vulnerable to Depression?
Why and How Adolescents Are Affected by Generalized Anxiety Disorder and Clinical Depression?
Does Depression Assist Eating Disorders?
What Should You Know About Depression?
How Can Mother Nature Lower Depression and Anxiety?
How Can Video Games Relieve Stress and Reduce Depression?
When Does Teacher Support Reduce Depression in Students?
Why Are Teenagers Affected by Depression?
How Teens and Depression Today?
Are Mental Health Issues Like Depression Related to Race?
What Does Depression Mean?
How Did the Depression Affect France?
How Does Depression Stop?
When Postpartum Depression Leads to Psychosis?
How Do Medication and Therapy Combat Depression?
What Are the Leading Causes of Depression?
What About Drugs for Anxiety and Depression?
What’s the Big Deal About Anxiety and Depression in Students?
How Should Childhood Depression and Anxiety Be?
How Do Gender Stereotypes Warp Our View of Depression?
What Are the Signs of Teenage Depression?
Are Testosterone Levels and Depression Risk Linked Based on Partnering and Parenting?
How Psychology Helps People With Depression?
How Should Childhood Depression and Anxiety Be Treated or Dealt With?
Early Diagnosis of Depression: Public Health Depression in young adults has become a significant health problem across the US. It causes persistent feelings of loss of interest in activities and sadness.
Depression and Social Media in Scientific vs. Popular Articles The damage can come in the form of misinformation, which can result in an unjustified and unnecessary self-restriction of social media.
Depression in Adolescence: Causes and Treatment Depression amongst young adults at the puberty stage comes in hand with several causes that one cannot imagine, and depression happens or is triggered by various reasons.
Addressing Depression Among Native Youths The current paper aims to utilize a Medicine Wheel model and a social work paradigm to manage depression among Native American Indian youths.
Psychological Assessments and Intervention Strategies for Depression The article presents two case studies highlighting the importance of psychological assessments and intervention strategies for individuals experiencing depression.
The Impact of Postpartum Maternal Depression on Postnatal Attachment This paper examines the influence of postpartum maternal depression on postnatal infant attachment, discusses the adverse effects of depression on attachment.
Marijuana Effects on Risk of Anxiety and Depression The current paper aims to find out whether medical cannabis can positively affect anxiety and depression and the process of their treatment.
Cognitive Behavioral Therapy for Anxiety and Depression Cognitive behavioral therapy analyzes the unconscious processes influencing the normal functioning of the human body, causing different pathologies.
Hypnotherapy as an Effective Method for Treating Depression This paper explores the use of hypnotherapy as a treatment for depression and highlights the advantages of hypnosis in addressing depressive symptoms.
Depression and Anxiety: Mary’s Case Mary’s husband’s death precipitated her depression and anxiety diagnosis. She feels lonely and miserable as she struggles with her daily endeavors with limited emotional support.
Postpartum Depression in Women and Men The focus of the paper is health problems that affect women after giving birth to a child, such as depression. The author proposes that men also experience postpartum depression.
Repression and Depression in “The Yellow Wallpaper” by Charlotte Perkins Gilman In “The Yellow Wallpaper” by Charlotte Perkins Gilman, the author highlighted the connection between repression and depression.
Men and Depression: Signs, Symptoms, Causes, and Treatment Depression in men and women has several incompatibilities as males suffer from health problems more often than women as they rarely express their emotions.
Promotion of Change Regarding Adolescent Depression In the essay, the author describes the methods to evaluate the symptoms of a patient who has been referred for counseling with depression.
Interventions to Cope With Depression Depression is characterized by sadness, anxiety, feelings of worthlessness, and helplessness. These feelings do not necessarily relate to life events.
Bipolar Depression and Bipolar Mania Although all bipolar disorders are characterized by periods of extreme mood, the main difference between them is the severity of the condition itself.
Post-Stroke Anxiety and Depression The purpose of the given study is to ascertain how cognitive behavior therapy affects individuals with post-stroke ischemia in terms of depression reduction.
Depression and Anxiety Management The medical staff will investigate the treatment modalities currently being utilized for the large population of patients experiencing symptoms of anxiety and depression.
Impacts of Stress of Low Income on the Risk of Depression in Children Socioeconomic hardships lead to a decline in the quality of parenting and the development of psychological and behavioral problems in children.
Depression: Diagnostics and Treatment Depression, when it remains unchecked, can cause detrimental effects to individuals, such as suicide, which will eventually equate to mental disorders.
Depression and Anxiety in Mental Health Nurses Depression and anxiety are the most common mental diseases in humans. Nurses who work in mental health are at significant risk of getting psychiatric illnesses.
Psychedelics in Depression and Anxiety Treatment Mental illnesses have become an essential part of health in the last few decades, with sufficient attention being devoted to interventions that resolve them.
Depression and Anxiety Among African-American Children Depression and anxiety are common among African-American children and adolescents, but they face significant barriers to receiving care and treatment due to their age and race.
Why Are Physical Activities Treatments for Depression? In this paper, the connection between physical activities and depression will be analyzed, and the common counterargument will be discussed.
Depression in the Older Population The paper discusses depression is an actual clinical disorder for older people with specific reasons related to their age.
Nutrition and Depression: A Psychological Perspective When discussing nutrition in toddlers and certain behavioral patterns, one of the first standpoints to pay attention to is the humanistic perspective.
Social Media and Depression in Adolescents: The Causative Link This paper explores how social media causes depression in adolescents during the social-emotional stage of life.
“Yoga for Depression” Article by The Minded Institute One can say that depression is both the biological and mental Black Death of modern humanity in terms of prevalence and negative impact on global health.
Therapeutic Interventions for the Older Adult With Depression and Dementia The paper researches the therapeutic interventions which relevant for the older people with depression and dementia nowadays.
Depression Among Patients With Psoriasis Considering psoriasis as the cause of the development of depressive disorders, many researchers assign a decisive role to the severe skin itching that accompanies psoriasis.
Qi Gong Practices’ Effects on Depression Qi Gong is a set of physical and spiritual practices aimed at the balance of mind, body, and soul and the article demonstrates whether it is good or not at treating depression.
The Effects of Forgiveness Therapy on Depression for Women The study analyzes the impact of forgiveness therapy on the emotional state of women who have experienced emotional abuse.
Relation Between the COVID-19 Pandemic and Depression The paper is to share an insight into the detrimental effects of the COVID-19 pandemic on the mental health of thousands of people and provide advice on how to reduce its impact.
Post-operative Breast Cancer Patients With Depression: Annotated Bibliography This paper is an annotated bibliography about risk reduction strategies at the point of care: Post-operative breast cancer patients who are experiencing depression.
How Covid-19 Isolation Contributed to Depression and Adolescent Suicide The pandemic affected adolescents because of stringent isolation measures, which resulted in mental challenges such as depression and anxiety, hence suicidal thoughts.
Is depression a biological condition or a result of unrealistic expectations?
Should employers be legally required to provide support to workers with depression?
Do the media portrayals of depression accurately reflect people’s experiences?
Social media contributes to depression rates by eliciting the feeling of loneliness.
Should mental health screening be mandatory in schools?
Should depression be reclassified as a neurological disorder?
Antidepressants are an overused quick-fix solution to depression.
Should non-pharmacological treatments for depression be prioritized?
Should depression be considered a disability?
The use of electroconvulsive therapy for depression should be banned.
Depression and Anxiety in Older Generation Depression and anxiety represent severe mental disorders that require immediate and prolonged treatment for patients of different ages.
Coping with Depression After Loss of Loved Ones This case is about a 60-year-old man of African American origin. He suffered from depression after his wife’s death, which made him feel lonely and isolated.
Postpartum Depression Screening Program Evaluation In order to manage the depression of mothers who have just delivered, it is important to introduce a routine postpartum depression-screening program in all public hospitals.
Depression: Symptoms, Causes and Treatment Depression interferes with daily routine, wasting valuable time and lowering production. Persistent downs or blues, sadness, and anger may be signs of depression.
Is Creativity A Modern Panacea From Boredom and Depression? Communication, daily life, and working patterns become nothing but fixed mechanisms that are deprived of any additional thoughts and perspectives.
Adolescent Males With Depression: Poly-Substance Abuse Depression is the most crucial aspect that makes young males indulge in poly-substance abuse. There are various ways in which male adolescents express their depression.
The Health of the Elderly: Depression and Severe Emotional Disturbance This study is intended for males and females over the age of 50 years who are likely to suffer from depression and severe emotional disturbance.
Suicidal Ideation & Depression in Elderly Living in Nursing Home vs. With Family This paper attempts to compare the incidence of suicidal ideation and depression among elderly individuals living in nursing homes and those living with family in the community.
Major Depression: Symptoms and Treatment Major depression is known as clinical depression, which is characterized by several symptoms. There are biological, psychological, social, and evolutionary causes of depression.
Health Disparity Advocacy: Clinical Depression in the U.S. Recent statistics show that approximately more than 10 million people suffer from severe depression each year in the U.S..
The Treatment of Anxiety and Depression The meta-analysis provides ample evidence, which indicates that CES is not only effective but also safe in the treatment of anxiety and depression.
Depression Intervention Among Diabetes Patients The research examines the communication patterns used by depression care specialist nurses when communicating with patients suffering from diabetes.
Postnatal Depression in New Mothers and Its Prevention Leisure activities keep new mothers suffering from postnatal depression busy and enable them to interact with other members of the society.
Literature Evaluation on the Depression Illness The evaluation considers the articles that study such medical illness as depression from different planes of its perception.
Treatment of Major Depression The purpose of the paper is to identify the etiology and the treatment of major depression from a psychoanalytic and cognitive perspective.
Edinburgh Depression Screen for Treating Depression Edinburgh Depression screen is also known as Edinburgh Postnatal Depression Scale which is used to screen pregnant and postnatal women for emotional distress.
Depression Treatment Variants in the US There is a debate regarding the best formula for depression treatment whereby some argue for using drugs, whereas others are advocating for therapy.
Effects of Music Therapy on Depressed Elderly People Music therapy has been shown to have positive effects among people, and thus the aim was to assess the validity of such claims using elderly people.
Depression in the Elderly: Treatment Options Professionals may recommend various treatment options, including the use of antidepressants, psychotherapy such as cognitive-behavioral therapy.
Depression Treatments and Therapeutic Strategies This article examines the effectiveness of different depression treatments and reviews the therapeutic strategies, which can be helpful if the initial treatment fails.
Depression and the Nervous System Depression is a broad condition that is associated with failures in many parts of the nervous system. It can be both the cause and the effect of this imbalance.
Depression: Types, Symptoms, Etiology & Management Depression differs from other disorders, connected with mood swings, and it may present a serious threat to the individual’s health condition.
The Effect of Music Therapy on Depression One major finding of study is that music therapy alleviates depression among the elderly. Music therapy could alleviate depression.
“Neighborhood Racial Discrimination and the Development of Major Depression” by Russell The study investigates how neighborhood racial discrimination influences this severe mental disorder among African American Women.
Adolescent Depression and Physical Health Depression in adolescents and young people under 24 is a factor that affects their physical health negatively and requires intervention from various stakeholders.
Family Support to a Veteran With Depression Even the strongest soldiers become vulnerable to multiple health risks and behavioral changes, and depression is one of the problems military families face.
Alcohol and Depression Article by Churchill and Farrell The selected article for this discussion is “Alcohol and Depression: Evidence From the 2014 Health Survey for England” by Sefa Awaworyi Churchill and Lisa Farrell.
Does Social Media Use Contribute to Depression? Social media is a relatively new concept in a modern world. It combines technology and social tendencies to enhance interaction through Internet-based gadgets and applications.
Negative Effects of Depression in Adolescents on Their Physical Health Mental disorders affect sleep patterns, physical activity, digestive and cardiac system. The purpose of the paper to provide information about adverse impacts of depression on health.
Depression in the Contemporary Society Public awareness about depression has increased in recent years, with more attention dedicated to the need for addressing this serious mental health illness and less stigmatization.
Elderly Depression: Symptoms, Consequences, Behavior, and Therapy The paper aims to identify symptoms, behavioral inclinations of older adults, consequences of depression, and treatment ways.
Components of the Treatment of Depression The most effective ways of treating people with depression include pharmacotherapy, psychotherapy or a combination of both.
Mood Disorders: Depression Concepts Description The essay describes the nature of depression, its causes, characteristics, consequences, and possible ways of treatment.
Geriatric Depression Diagnostics Study Protocol The research question is: how does the implementation of the National Institute for Health and Care Excellence guidelines affect the accuracy of diagnosing of depression?
Protective Factors Against Youthful Depression Several iterations of multiple correlation, step-wise and hierarchical regression yielded inconclusive results about the antecedents of youthful depression.
Can physical exercise alone effectively treat depression?
Art therapy as a complementary treatment for depression.
Is there a link between perfectionism and depression?
The influence of sleep patterns on depression treatment outcomes.
Can exposure to nature and green spaces decrease depression rates in cities?
The relationship between diet and depression symptoms.
The potential benefits of psychedelic-assisted therapy in treating depression.
The role of outdoor experiences in alleviating depression symptoms.
The relationship between depression and physical health in older adults.
The role of workplace culture in preventing employee depression.
Depression and Other Antecedents of Obesity Defeating the inertia about taking up a regular programme of sports and exercise can be a challenging goal. Hence, more advocacy campaigns focus on doing something about obesity with a more prudent diet.
Depression and Related Psychological Issues Depression as any mental disorder can be ascribed, regarding the use of psychoanalysis, to a person`s inability to control his destructive or sexual instincts or impulses.
Television Habituation and Adolescent Depression The paper investigates the theory that there is a link between heavy TV viewing and adolescent depression and assess the strength of association.
Physiological Psychology. Postpartum Depression Depression is a focal public health question. In the childbearing period, it is commoner in females than in males with a 2:1 ratio.
Adolescent Depression: Modern Issues and Resources Teenagers encounter many challenging health-related issues; mental health conditions are one of them. This paper presents the aspects of depression in adolescents.
Depression Among Rich People Analysis Among the myriad differences between rich and poor people is the manner in which they are influenced by and respond to depression.
Occupational Psychology: Depression Counselling The case involves a 28-year-old employee at Data Analytics Ltd. A traumatic event affected his mental health, causing depression and reduced performance.
Psychotherapeutic Group: Treatment of Mild-To-Moderate Depression The aim of this manual is to provide direction and employ high-quality sources dedicated to mild-to-moderate depression and group therapy to justify the choices made for the group.
Transition Phase of Depression and Its’ Challenges Providing psychoeducation to people with mild to moderate depression, strategies for recognizing and addressing conflict and reluctance are discussed in this paper
“Depression and Ways of Coping With Stress” by Orzechowska et al. The study “Depression and Ways of Coping With Stress” by Orzechowska et al. aimed the solve an issue pertinent to nursing since depression can influence any patient.
Action Research in Treating Depression With Physical Exercise Depression is one of the most common mental health disorders in the United States. The latest statistics showed that depression does not discriminate against age.
Postpartum Depression: Evidence-Based Practice Postpartum or postnatal depression refers to a mood disorder that can manifest in a large variety of symptoms and can range from one person to another.
Effectiveness of Telenursing in Reducing Readmission, Depression, and Anxiety The project is dedicated to testing the effectiveness of telenursing in reducing readmission, depression, and anxiety, as well as improving general health outcomes.
Adult Depression Treatment in the United States This study characterizes the treatment of adult depression in the US. It is prompted by the findings of earlier studies, which discover the lack of efficient depression care.
Nurses’ Interventions in Postnatal Depression Treatment This investigation evaluates the effect of nurses’ interventions on the level of women’s postnatal depression and their emotional state.
Postpartum Depression: Evidence-Based Care Outcomes In this evidence-based study, the instances of potassium depression should be viewed as the key dependent variable that will have to be monitored in the course of the analysis.
Postpartum Depression: Diagnosis and Treatment This paper aims to discuss the peculiarities of five one-hour classes on depression awareness, to implement this intervention among first-year mothers, and to evaluate its worth during the first year after giving birth.
Homelessness and Depression Among Illiterate People There are various myths people have about homelessness and depression. For example, many people believe that only illiterate people can be homeless.
Postpartum Depression In First-time Mothers The most common mental health problem associated with childbirth remains postpartum depression, which can affect both sexes, and negatively influences the newborn child.
The Diagnosis and Treatment of Postpartum Depression Postpartum depression has many explanations, but the usual way of referring to this disease is linked to psychological problems.
What Is Postpartum Depression? Causes, Symptoms, and Treatment The prevalence of postpartum depression is quite high as one in seven new American mothers develops this health issue.
Baby Blues: What We Know About Postpartum Depression The term Postpartum Depression describes a wide variety of physical and emotional adjustments experienced by a significant number of new mothers.
Depression in Adolescence as a Contemporary Issue Depression in adolescents is not medically different from adult depression but is caused by developmental and social challenges young people encounter.
Predictors of Postpartum Depression The phenomenon of postpartum depression affects the quality of women’s lives, as well as their self-esteem and relationships with their child.
Depression and Self-Esteem: Research Problem Apart from descriptively studying the relationship between depression and self-esteem, a more practical approach can be used to check how interventions for enhancing self-esteem might affect depression.
The Relationship Between Depression and Self-Esteem The topic which is proposed to be studied is the relationship between depression and self-esteem. Self-esteem can be defined as individual’s subjective evaluation of his or her worth.
The Impact of Depression on Motherhood This work studies the impact of depression screening on prenatal and posts natal motherhood and effects on early interventions using a literature review.
Depression and Workplace Violence The purpose of this paper is to provide an in-depth analysis how can workplace violence and verbal aggression be reduced or dealt with by employees.
Depression in Female Cancer Patients and Survivors Depression is often associated with fatigue and sleep disturbances that prevent females from thinking positively and focusing on the treatment and its outcomes.
Treating Mild Depression: Psychotherapy and Pharmacotherapy The project intends to investigate the comparative effectiveness of the treatments that are currently used for mild depression.
The Geriatric Population’s Depression This paper discusses how does the implementation of National Institute for Health and Care guidelines affect the accuracy of diagnosing of depression in the geriatric population.
Problem of Depression: Recognition and Management Depression is a major health concern, which is relatively prevalent in the modern world. Indeed, in the US, 6.7 % of adults experienced an episode of the Major Depressive Disorder in 2015.
Health and Care Excellence in Depression Management The introduction of the National Institute for Health and Care Excellence guidelines can affect the accuracy of diagnosing and quality of managing depression.
Theories in Depression Treatment This study analyzes the theories pertinent to depression treatment, reviews relevant evidence, defines key concepts of the project, and explains the framework chosen for it.
Impact of COVID-19 on Depression and Suicide Rates among Adolescents and Young People The purpose of this paper is to explore the influence of coronavirus on these tragic numbers.
Mild Depression: Psychotherapy or Pharmacotherapy The research question in this paper is: in psychiatric patients with mild depression, what is the effect of psychotherapy on health compared with pharmacotherapy?
Postpartum Bipolar Disorder and Depression The results of the Mood Disorder Questionnaire screening of a postpartum patient suggest a bipolar disorder caused by hormonal issues and a major depressive episode.
Bipolar Disorder or Manic Depression Bipolar disorder is a mental illness characterized by unusual mood changes that shift from manic to depressive extremes. In the medical field, it`s called manic depression.
The Improvement of Depression Management The present paper summarizes the context analysis that was prepared for a change project aimed at the improvement of depression management.
Depression Management in US National Guidelines The project offers the VEGA medical center to implement the guidelines for depression management developed by the National Institute for Health and Care Excellence.
Women’s Health and Major Depression Symptoms The client’s complaints refer to sleep problems, frequent mood swings (she gets sad a lot), and the desire to stay away from social interactions.
Predictors of Postpartum Depression: Who Is at Risk? The article “Predictors of Postpartum Depression” by Katon, Russo, and Gavin focuses on the identification of risk factors related to postnatal depression.
Depression and Its Treatment: Racial and Ethnic Disparities The racial and ethnic disparities in depression treatment can be used for the development of quality improvement initiatives aimed at the advancement of patient outcomes.
Lamotrigine for Bipolar Depression Management Lamotrigine sold as Lamictal is considered an effective medication helping to reduce some symptoms that significantly affect epileptic and bipolar patients’ quality of life.
Citalopram, Methylphenidate in Geriatric Depression Citalopram typically ranges among 10-20 antidepressants for its cost-effectiveness and positive effect on patients being even more effective than reboxetine and paroxetine.
Depression and Self-Esteem Relationship Self-esteem can be defined as an “individual’s subjective evaluation of his or her worth as a person”; it does not necessarily describe one’s real talents.
Postpartum Depression: Methods for the Prevention Postpartum depression is a pressing clinical problem that affects new mothers, infants, and other family members. The prevalence of postpartum depression ranges between 13 and 19 percent.
Anxiety and Depression Among Females with Cancer The study investigated the prevalence of and the potential factors of risk for anxiety and/or depression among females with early breast cancer during the first 5 years.
Post-Partum Depression and Perinatal Dyadic Psychotherapy Post-partum depression affects more than ten percent of young mothers, and a method Perinatal Dyadic Psychotherapy is widely used to reduce anxiety.
VEGA Medical Center: Detection of Depression Practice guidelines for the psychiatric evaluation of adults, and they can be employed to solve the meso-level problem of the VEGA medical center and its nurses.
The Postnatal (Postpartum) Depression’ Concept Postnatal or postpartum depression (PPD) is a subtype of depression which is experienced by women within the first half a year after giving birth.
Postpartum Depression, Prevention and Treatment Postpartum depression is a common psychiatric condition in women of the childbearing age. They are most likely to develop the disease within a year after childbirth.
Smoking Cessation and Depression Problem The aim of the study is to scrutinize the issues inherent in the process of smoking cessation and align them with the occurrence of depression in an extensive sample of individuals.
Evidence-Based Pharmacology: Major Depression In this paper, a certain attention to different treatment approaches that can be offered to patients with depression will be paid, including the evaluation of age implications.
The Efficacy of Medication in Depression’ Treatment This paper attempts to provide a substantial material for the participation in an argument concerning the clinical effectiveness of antidepressant medications.
Depression and Cognitive Psychotherapy Approaches Cognitive psychotherapy offers various techniques to cope with emotional problems. This paper discusses the most effective cognitive approaches.
Treatment of Depression in Lesbians The aim of this paper is to review a case study of 45 years old lesbian woman who seeks treatment for depression and to discuss the biophysical, psychological, sociocultural, health system.
Women’s Health: Predictors of Postpartum Depression The article written by Katon, Russo, and Gavin is focused on women’s health. It discusses predictors of postpartum depression (PPD), including sociodemographic and clinic risk factors.
Depression Treatment and Management Treatment could be started only after patient is checked whether he has an allergy to the prescribed pills or not. If he is not allergic, he should also maintain clinical tests for depression.
Counseling Depression: Ethical Aspects This paper explores the ethical aspects required to work with a widower who diminished passion for food, secluding himself in the house, portraying signs of depression.
Postpartum Depression as Serious Mental Health Problem The research study aimed to evaluate the effectiveness of a two-step behavioral and educational intervention on the symptoms of postpartum depression in young mothers.
European Alliances, Wars, Dictatorships and Depression The decades leading to World War I had unusual alignments. The European nations were still scrambling for Asia, Africa and parts of undeveloped Europe.
Women’s Health: Depression as a Psychological Factor Women who identify themselves as lesbian are likely to experience depression. Biophysical, psychological, sociocultural, behavioral, and health system factors should be taken into consideration.
Childhood Obesity and Depression Intervention The main intervention to combat depressive moods in adolescents should be linked to improving the psychological health of young people in cooperation with schools.
Postpartum Depression: Prevalence, Risks, and Impact The paper analyzes the prevalence and risk factors of Postnatal (Postpartum) Depression as well as investigates the effect on the newborns whose mothers suffer from this condition.
Smoking Cessation and Depression It was estimated that nicotine affects the human’s reward system. As a result, smoking cessation might lead to depression and other mental disorder.
Placebo and Treatments for Depression Natural alternative treatments for depression actually work better than the biochemical alternatives like antidepressants.
Care for Depression in Obstetrics and Gynecology This work analyzes the article developed by Melville et al. in which discusses the theme of depression in obstetrics and gynecology and improving care for it.
Effective Depression Screening in Long-Term Conditions Screening for depression in patients suffering from long term conditions (LTCs) or persistent health problems of the body, could largely be erroneous.
Patients with Depression’ Care: Betty Case Betty, a 45 years old woman, is referred to a local clinic because of feeling depressed. She has a history of three divorces and thinks that she is tired of living the old way.
Clinical Depression Treatment: Issues and Solvings The paper describes and justifies the design selected for research on depression treatment. It also identifies ethical issues and proposes ways of addressing them.
Effectiveness of Integrative and Instrumental Reminiscence Therapies on Depression This article presents the research findings of a study conducted in Iran to assess how effective integrative and instrumental therapies are in the management of depression in older persons.
Major Types of Depression This paper will review and analyze two scholarly articles concerning depression, its sings in male and female patients, and its connection and similarity to other disorders.
Depression in the Elderly – Psychology This paper discusses how a person would know whether a relative had clinical depression or was sad due to specific changes or losses in life.
Depression in the Elderly Depression can be defined as a state of anxiety, sadness, hopelessness, and worthlessness. It can affect people across all ages, who present with diverse signs and symptoms
Postnatal Depression: Prevalence of Postnatal Depression in Bahrain The study was aimed at estimating the prevalence of postnatal depression among 237 Bahraini women who attended checkups in 20 clinical centres over a period of 2 months.

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A Qualitative Study of Depression in Primary Care: Missed Opportunities for Diagnosis and Education

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Purpose: Depression is one of the most commonly encountered chronic conditions in primary care, yet it remains substantially underdiagnosed and undertreated. We sought to gain a better understanding of barriers to diagnosis of and entering treatment for depression in primary care.

Methods: We conducted and analyzed interviews with 15 subjects currently being treated for depression recruited from primary care clinics in an academic medical center and an academic public hospital. We asked about experiences with being diagnosed with depression and starting treatment, focusing on barriers to diagnosis, subject understanding of depression, and information issues related to treatment decisions.

Results: Subjects reported many visits to primary care practitioners without the question of depression being raised. The majority had recurrent depression. Many reported that they did not receive enough information about depression and its treatment options. In the majority of cases, practitioners decided the course of treatment with little input from the patients.

Conclusions: In this sample of depressed patients, we found evidence of frequent missed diagnoses, substantial information gaps, and limited patient understanding and choice of treatment options. Quality improvement efforts should address not only screening and follow-up but patient education about depression and treatment options along with elicitation of treatment preferences.

Depression is a common mental health problem leading to significant morbidity and mortality and high medical and societal costs. 1–3 The World Health Organization estimated that major depression caused more disability worldwide in 1990 than ischemic heart disease or cerebrovascular disease. 4 The prevalence of major depressive disorders in the US population aged 18 years and older has been estimated at 5%, 5 and it is one of the most commonly encountered conditions in primary care, 6 ,7 but up to 50% of cases go unrecognized. 8 ,9 In many cases, it is more appropriately viewed as a chronic disorder with remissions and relapses than an acute illness. 10–12

Even if diagnosed, care for depression is frequently flawed. Many persons diagnosed with depression do not commence treatment for it, 9 and the majority of persons who do enter treatment do not receive their preferred type of treatment, even though this seems to lead to better outcomes. 13 ,14 Furthermore, many persons starting treatment do not complete an adequate treatment course. 15 The US Preventive Services Task Force “recommends screening adults for depression in clinical practices that have systems in place to assure accurate diagnosis, effective treatment, and follow-up” with a grade B recommendation, 16 as such systems have been demonstrated to improve health status and, in some instances, to reduce health care costs. 17–20

There is a remarkable paucity of information about patients’ understanding of depression and its treatment options, and the role patients play in choosing treatment options. The very limited evidence available suggests quite modest benefits of patient education materials for depression in isolation from more comprehensive interventions. 21 ,22 Some studies have included patient informational materials as part of a systematic intervention, but not evaluated them separately. 14 ,17 ,19 In some cases, patient education materials may have more of a medical than a patient-centered orientation and may not address a number of patients’ key questions. 23

In this study, we report results of qualitative analyses of interviews with patients currently under treatment for depression about their experiences with being diagnosed with and starting treatment for depression. We specifically sought to explore their understanding of depression before and after receiving the diagnosis, sources and adequacy of information about depression and its treatment options, and their roles in choosing treatment options. We chose a qualitative approach because of the limited extant information in this area to “map the terrain” and be open to unexpected findings.

Participant Recruitment

Subjects were recruited by posting flyers in primary care clinics affiliated with the University of Washington Medical Center, an academic medical center, and at Harborview Medical Center, a public/teaching hospital affiliated with the University of Washington. We advertised for persons who had been diagnosed with depression within the past year. Persons who had been diagnosed with depression, spoke English, and were able to give informed consent were eligible to participate in the study. This study was approved by the University of Washington’s Human Subjects Institutional Review Board.

Conduct of Interviews

We conducted semistructured, qualitative interviews lasting 30 to 60 minutes with 15 subjects currently undergoing treatment for depression. Subjects were interviewed by 2 study members, with one acting as primary interviewer and the other focusing more on detailed note taking, with the exception of 3 cases where only 1 team member was available. A family physician-investigator (BGS) participated in 11 of the 15 interviews. The backgrounds of the other interviewers were education (VV-N) and public health (GK). Each interviewer took typewritten notes during the interviews, touch typing and maintaining eye contact with subjects and only rarely asking for brief pauses to catch up on note taking. Notes were checked for consistency and merged after the interviews.

Interviews were structured around a set of root questions covering subjects’ experience of and perspectives on being diagnosed with depression, receiving information about the diagnosis, receiving information about treatment options, and deciding to start treatment for depression. Each root question was followed by a number of probe questions to flesh out detail in subjects’ responses. Subjects were asked about their current episode of depression and any previous episodes. The template for the root and probe questions is contained in the Appendix.

Data Analysis

We used a qualitative descriptive approach 24 based on our interview template. Using notes from the first 3 interviews, 3 researchers (BGS, VV-N, and GK) who participated in the interviewing process independently classified statements according to this schema, first into the major categories underlying our interview template and then into subcategories as we identified them in the data. We added new categories and subcategories for statements not fitting this framework, and searched for themes and concepts common to these interviews. These 3 researchers then compared results and, through an interactive process of discussion, reflection, and scrutiny of the interview template, interview notes, and initial coding, arrived at consensus on a refined coding scheme. Using this coding scheme, 2 researcher-interviewers (VV-N and GK) independently coded the remaining interview notes using QSR NVivo 2.0 (Qualitative Systems and Research, Australia, 2002) and met to compare different perspectives and interpretations of ambiguous data and identification of concepts not covered by the coding scheme; differences were reconciled with no significant disagreements. The other researcher-interviewer (BGS) reviewed all the notes and coding for consistency and to ensure that no significant concepts or themes had been overlooked or statements misclassified or left uncoded. This resulted in coding of a few additional statements with the existing coding scheme but no new categories or disagreements with the coding assignments.

Given our a priori descriptive goals, we did not seek to generate new theories about depression in primary care; rather, we focused on describing common experiences and identifying gaps and barriers that might be amenable to interventions to improve depression care for future patients.

The 15 participants ranged in age from their mid-20s to their late 50s, with about half in their mid-40s, and were evenly split between males and females. There were 7 Caucasian, 6 African American, 1 Asian American, and 1 Native American subjects. Six participants reported college or graduate degrees, and 6 more reported some college education. Four subjects mentioned a diagnosis of bipolar disorder, 3 reported anxiety disorders, and 5 gave histories of substance use problems. We chose to retain and analyze interviews with participants reporting a diagnosis of bipolar disorder, because their reported experiences with depression diagnosis and treatment were quite similar to those of our participants not reporting a bipolar diagnosis, and depression is a common presentation of bipolar disorder. Similarly, we have retained the participants in our sample who reported histories of substance use as the issues raised by these participants were very much the same as those raised by other participants, with the addition of active substance use being a barrier to willingness to undertake treatment for depression.

A majority of our participants reported being diagnosed with depression by a mental health care practitioner, but a substantial minority reported receiving an initial diagnosis from a primary care practitioner (PCP). One third reported their initial diagnosis came as a result of an emergency department visit. All subjects reported limited understanding of depression before their initial diagnosis. None reported having, before diagnosis, acquaintance with views of depression as a frequently heritable condition involving neurotransmitters in the brain, regardless of their educational attainment. Sample comments illustrating subjects’ reported understanding of depression before their initial diagnoses are presented in Table 1 .

View inline

Participant Statements about Prediagnosis Understanding of Depression

Participants frequently reported incidents of missed diagnosis during visits to PCPs. As exemplified by quotes in Table 2 , reasons cited for missed diagnoses fell into 2 categories: patient-related and practitioner-related factors. Some subjects expressed either inability or unwillingness to raise the issue with their practitioners. Others reported that practitioners were unsuspecting, focusing on the subjects’ somatic complaints (depression-related or otherwise), seemed uninterested in the possibility of nonphysical issues, or were frankly dismissive of the diagnosis when the subject raised it with them.

Participant Statements about Missed Diagnoses of Depression

Only a few participants reported receiving helpful verbal information from their PCPs, also in some cases accompanied by being referred to a patient information library; most reported receiving little or no information from their PCPs about depression. Of the 13 participants who had seen a mental health care practitioner at any point, a majority reported receiving information about depression; a minority felt the information they received from mental health professionals was inadequate. Some subjects reported seeking out information from other sources, such as books, broadcast media, and the internet. Representative comments about sources of information about the diagnosis of depression are shown in Table 3 .

Participant Statements Regarding Sources of Information about Depression

A number of subjects reported having received written information, but this information was frequently recalled as not very helpful. The participants who reported doing their own research about depression proved more informed about current understanding of the genetics and neurobiology of depression than those who had not. Two persons specifically commented that learning about this helped them stop blaming themselves for their depression (see quotes in Table 3 ).

Many participants reported barriers to obtaining information about depression and its treatment. These could be grouped into several categories: lack of motivation due to depression, stigma of depression and/or denial of the diagnosis, practitioners seeming unresponsive, and a mismatch between their preferred mode of learning and how information was offered. Quotes exemplifying these issues are provided in Table 4 .

Participant Statements about Barriers to Getting Information about Depression

Fewer than half of our subjects reported being given any information about counseling as a treatment option. None remembered being given any explanation of what counseling options, such as cognitive-behavioral therapy, problem-solving therapy, and interpersonal therapy, might be like.

Only a minority of the participants indicated that they felt they had had some say in their treatment decisions and even where they did, not all felt they had sufficient information to make a good choice. However, not all wanted to make this choice, with some preferring to trust their practitioners to make the choice. Quotes pertaining to issues of role in choice of therapy are shown in Table 5 .

Participant Statements about Participation in Treatment Decisions

Because almost 75% of patients who seek help for depression do so in primary care settings, 3 substantial improvement in the quality of care for depression must address deficits in primary care. Our interviews highlight some key areas where depression care might be improved: screening for depression; patient education about current understanding of depression and treatment options; improving provider attitudes and knowledge about depression and its treatment where there are gaps; and increasing the collaborative nature of decision making about treatment options.

Our participants reported frequent missed diagnoses, even among persons with recurrent depression. Although one might debate the value of universal screening, particularly in the widespread absence of “systems in place to assure accurate diagnosis, effective treatment, and follow-up,” 16 use of practice-based information systems to implement screening for recurrent depression among persons with past diagnoses might well be efficient and cost-effective in the current practice environment.

As noted above, the limited evidence on educational interventions for depression 21 ,22 does not suggest that education alone is likely to be particularly effective in improving outcomes of depression treatment. However, education is a key component of self-management support, facilitating patients in taking active roles in commencing and continuing treatment. Our participants reported that they generally received limited information from practitioners about depression and the treatment options available, both in primary care and mental health care settings. Most reported that they would have liked more information. A number of barriers to obtaining information were reported, with both patient-related and practitioner-related factors appearing important.

Although this study did not specifically address stigma associated with depression, several of our participants raised this issue. and other studies have shown that stigma is a major barrier to diagnosis and treatment of depression. 3 ,25–28 Education may help to reduce personal stigma associated with depression. 22

Most of our participants reported that they would have liked more say in their choice of treatments. Implementing systems to solicit treatment preferences of persons diagnosed with depression and coordination with counseling resources could substantially improve outcomes given the evidence that providing patients with their preferred mode of treatment increases both treatment uptake and adherence 13 ,14 and that more patients seem to desire counseling versus medication for treatment of depression. 29–31

A number of limitations of this study must be acknowledged. First, being based on a limited number of interviews with volunteer participants recruited from outpatient clinics at 2 hospitals associated with a single teaching institution, we cannot know how well our finding generalize to the universe of persons under treatment for depression in the US. Both sites probably have an overrepresentation of persons with significant, chronic mental health issues. Volunteers may well differ in many ways from “average” patients with depression. Second, recall of our participants may have been incomplete and/or biased. Depression can interfere with both memory and motivation, so it is possible that some subjects received information and/or choices that they did not recall during the interviews. Third, as with most research, our findings and conclusions are subject to potential bias from our preconceptions and prejudices. Our budget did not permit transcription of interview recordings and we did not record the interviews, so choices about what to record in our notes could influence our findings. However, having 2 persons simultaneously take notes in 12 of the 15 cases should have minimized effects of selective recording of information. Fourth, having only interviewed persons engaged in active treatment for depression, we cannot generalize our findings to those who declined or stopped therapy. Fifth, we had anticipated our participants would primarily be persons who had received new diagnoses of depression in the primary care setting within the previous year, but many had chronic or recurrent depression and were seeing or had seen mental health practitioners. Our interview template did not have probes to clearly delineate the separate roles of primary care and mental health specialty care and the coordination of care between them. Sixth, we have no way of knowing whether addressing the shortcomings in diagnosis and patient education about depression we have identified will, in fact, improve outcomes of depression treatment.

However, our findings are consistent with existing literature on shortcomings in diagnosis and treatment of depression. Addressing these deficits would enhance the patient-centeredness of care for depression and offers the potential to improve engagement with and outcomes of treatment for depression.

Background Information

Years diagnosed with depression

6. How was your depression diagnosed?

Did you go to the doctor specifically because you thought you were depressed and wanted help?

If not, what made you go to the doctor?

Had you been to the doctor earlier, while you were depressed, without having the question of depression brought up?

If so, why do you think it didn’t come up?

Had you been diagnosed with or treated for depression previously?

Recognizing Depression:

7. What was your understanding of depression before you were diagnosed?

Source of information/understanding depression

8. What information were you given about depression?

What information were you given when the diagnosis was made?

How was it given? For example, did the doctor talk with you to help you understand about depression? Were you given written materials? Referred to books, web resources, or something else?

Did you feel you had enough information?

If not, what else did you want to know?

What prevented you from learning more? (For example, no time left in the visit, information was too hard to understand at the time, information was just not offered, or other.)

Information on treatment options

9. Did you feel you were given enough information about treatment options to make a good choice?

Did you learn about both counseling and medications?

Did you understand what counseling for depression generally involves?

Did you hear about the different types of antidepressant medications (such as tricyclic antidepressants and SSRIs) and the pros and cons of each?

How was the information provided? For example, did the doctor talk with you? Were you given written materials? Referred to books, web resources, or something else?

Did you feel you had enough information to make a good choice?

If not, what else would you have liked to know?

Treatment decision

10. After the discussion of depression as a diagnosis, did you decide to start treatment?

If not then why not?

Did you later start treatment? If so, why?

What had changed?

If no change then explain why?

Continued treatment

11. If you started treatment, how soon after this was your next contact with your provider?

12. Did you initiate the contact or did they? (E.g., someone from your doctor’s office called you or they scheduled a follow-up appointment a week or two after you decided to start treatment.)

13. Do you have any thoughts about things that would have improved the diagnosis and treatment of your depression? This might be helping it be diagnosed sooner, helping you understand the diagnosis better, helping you understand treatment options better, helping you start treatment, or helping you stick with treatment.

14. Do you have any other thoughts about how doctors can do a better job helping people with depression?

This article was externally peer-reviewed.

Prior presentation : A portion of this work was presented at the 33rd North American Primary Care Research Group Annual Meeting, Quebec City, Quebec, October 15–18, 2005.

Conflict of interest : none reported.

Received for publication February 8, 2006.
Revision received September 27, 2006.
Accepted for publication October 5, 2006.
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Patient experiences of psychological therapy for depression: a qualitative metasynthesis

Susan McPherson ORCID: orcid.org/0000-0002-9478-9932 1 ,
Claire Wicks 1 &
Ilaria Tercelli 1

BMC Psychiatry volume 20 , Article number: 313 ( 2020 ) Cite this article

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Globally, national guidelines for depression have prioritised evidence from randomised controlled trials and quantitative meta-analyses, omitting qualitative research concerning patient experience of treatments. A review of patient experience research can provide a comprehensive overview of this important form of evidence and thus enable the voices and subjectivities of those affected by depression to have an impact on the treatments and services they are offered. This review aims to seek a comprehensive understanding of patient experiences of psychological therapies for depression using a systematic and rigorous approach to review and synthesis of qualitative research.

PsychINFO, PsychARTICLES, MEDLINE, and CINAHL were searched for published articles using a qualitative approach to examine experiences of psychological therapies for depression. All types of psychological therapy were included irrespective of model or modes of delivery (e.g. remote or in person; group or individual). Each article was assessed following guidance provided by the Critical Appraisal Skill Programme tool. Articles were entered in full into NVIVO and themes were extracted and synthesized following inductive thematic analysis.

Thirty-seven studies, representing 671 patients were included. Three main themes are described; the role of therapy features and setting; therapy processes and how they impact on outcomes; and therapy outcomes (benefits and limitations). Subthemes are described within these themes and include discussion of what works and what’s unhelpful; issues integrating therapy with real life; patient preferences and individual difference; challenges of undertaking therapy; influence of the therapist; benefits of therapy; limits of therapy and what happens when therapy ends.

Conclusions

Findings point to the importance of common factors in psychotherapies; highlight the need to assess negative outcomes; and indicate the need for patients to be more involved in discussions and decisions about therapy, including tailoring therapy to individual needs and taking social and cultural contexts into account.

Peer Review reports

In the United Kingdom (UK), United States (US) and other developed economies, evidence based treatment guidelines can influence the varieties of treatments made available to people formally diagnosed with depression, including the UK National Institute for Health and Care Excellence (NICE) guideline on depression [ 1 ]; the American Psychiatric Association guideline [ 2 ]; the European Psychiatric Association (EPA) guideline on psychotherapies for chronic forms of depression [ 3 ]; and the more recent American Psychological Association depression guideline [ 4 ]. All of these guidelines prioritise Randomised Controlled Trials (RCTs) and quantitative meta-analyses of trials as might be expected, since this is a key feature of the evidence based medicine paradigm. Yet there are also different emphases within these guidelines, reflecting the contested nature of evidence and interpretation within the paradigm.

As a result of differences in approach to trial evidence and synthesis and the ways that guideline committees are formed and operate, variations appear in terms of which psychological treatments are recommended for depression in adults and whether these are recommended as a range of choices or as a hierarchical list. For example, EPA recommends, for persistent depression, Cognitive Behavioural Analysis System of Psychotherapy and Interpersonal Therapy (IPT) as first and second line treatments with Cognitive Behavioural Therapy (CBT), Psychodynamic Psychotherapy (PP), Problem Solving Therapy (PST), Schema Therapy, Radical Openness Dialectical Behaviour Therapy and Mindfulness Based Cognitive Therapy (MBCT) as third line treatments; whereas the American Psychological Association recommends Behavioural Therapy, Cognitive Therapy, CBT, MBCT, IPT, PP or supportive therapy (with no particular hierarchy).

Since 2008, the UK has established a national psychological therapy service which has provided NICE recommended therapies for depression and anxiety. Over 900,000 people access these services every year, and the National Health Service aims to increase this figure to at least 1.5m by 2021 [ 5 ]. Although initially only providing CBT (following the hierarchy of recommendations in the 2004 NICE depression guideline), therapies available in these services have expanded slightly in some areas to other ‘evidence based’ therapies as determined by NICE updates. NICE depression guidelines to date have been significantly more complex than other guidelines in terms of the sub-classification of depression, branding of therapies and hierarchical ordering of treatments and prescription of specific combinations.

Although many guidelines refer to the importance of patient choice and experience, none of them include a review of qualitative research concerning patient experience of treatments. It has been noted that a review of patient experience research is critical in order to enable the voices and subjectivities of those affected by depression to have an impact on the treatments and services they are offered, in keeping with a drive for a more patient-centred health service [ 6 ]. Such a review could usefully inform guidelines as well as psychological treatment approaches in practice, since service user preferences for particular psychological approaches are known to be associated with better outcomes, a sense of fulfilment and fewer dropouts [ 7 ]. RCTs are relatively poorly equipped as a methodology to provide sufficient detail on process, context and individual differences that might support patients to make more informed choices.

When presented with findings of an RCT of psychological therapy for depression, service users and carers reported that the findings were of limited value in enabling informed choice since it failed to reveal the complex processes in therapy that often depended on unique therapist and patient variables [ 8 ]. A review and synthesis of qualitative studies concerning patient experiences of psychotherapies could therefore provide a useful source of information for patients and primary care professionals discussing individual treatment options which take social and individual factors into account. It has also been noted that RCTs of psychological therapies often fail to collect sufficient data on adverse effects [ 9 ] partly owing to an assumption that talking therapies have limited potential for harm. Given the lack of systematic monitoring of adverse outcomes and that RCTs consistently use researcher selected (as opposed to patient-preferred) outcome measures, a review of qualitative research could identify whether there are any specific types of harm or benefits that might be important to monitor in future research or address in treatment manuals and practitioner training.

Qualitative research is increasingly used in health service research to understand subjective experiences of conditions and treatments and has been increasingly used in psychotherapy research. There are a range of approaches to synthesising sets of qualitative studies deriving from different disciplines, such as meta-ethnography (from anthropology) or ‘formal grounded theory’ from sociology [ 10 ]; a common aim is to generate an overall comprehensive synthesis of the available individual qualitative studies on the topic. Approaches to metasynthesis vary in the way in which data is synthesised and analysed, but tend to be underpinned by the notion of systematically searching for and identifying primary qualitative research on the same topic and abstracting the findings to a ‘meta’ level. Qualitative metasynthesis is related to, but not identical to secondary data analysis, in that the primary data sets of each study are not available to reviewers. In this sense, qualitative metasynthesis is limited in terms of its relative distance from the first person raw material, relying on author interpretations of primary data. While some approaches to qualitative metasynthesis make use of the selected raw data within primary research reports (e.g. [ 11 ]), this could lead to bias. Sandelowski and Barroso have argued that the ‘data’ within a metasynthesis should therefore consist of study findings (author interpretations) rather than raw data [ 12 ]; the latter approach has been applied in the current review.

The aim of the present review is to synthesise existing qualitative evidence concerning patient experiences of psychological treatments for depression with a view to improving informed choice and informed consent to psychological treatment. No comprehensive review of this body of literature has been carried out to date. The 2009 NICE guideline included a chapter on patient experiences; however, this focused on experiences of depression, management and coping, rather than experiences of treatments. The chapter included a secondary analysis of 38 ‘healtalkonline’ accounts but with very limited analysis concerning psychosocial treatments (p88–90). The chapter also presented a narrative review of selective literature: a systematic review of nine studies about experiences of self-help in primary care [ 13 ]; a study of experiences of depression based on the same 38 healthtalkonline accounts [ 14 ]; and a further study on patient experiences of primary care [ 15 ]. In the Khan et al. [ 13 ] review, one of the 9 studies [ 16 ] looked at experiences of therapy (and is included in the present review). Therefore, although this chapter in the NICE guideline acknowledges aspects of patient experience, it does not constitute a review of patient experiences of therapy which could inform treatment recommendations and patient choice.

A previous qualitative metasynthesis reviewed eight studies of patient experiences of computerised CBT for depression or anxiety [ 11 ]. The scope differed to the current review in that it included adolescents as well as adults and included people with anxiety disorders. Two of the studies reviewed are included in the present review. However, given the narrow focus on the single delivery mode, there remain questions about what the broader body of literature on patient experiences of psychological treatments for depression might reveal about the overall landscape of psychological therapy provision.

The current review aimed to seek a comprehensive understanding of patient experiences of psychological therapies for depression across all modalities, using a systematic and rigorous approach [ 10 ]. Studies included participants who were adults with depression who had received psychological treatment for depression. Studies were qualitative and had explored patient experiences using qualitative interviews or focus groups.

Data sources

An electronic search was conducted in June 2019 using the databases PsychINFO, PsychARTICLES, MEDLINE, and CINAHL.

Search strategy

The search terms were chosen with a view to identifying studies concerned with depression using a qualitative approach and focusing on experiences of psychological therapies (broadly defined). Some specific therapies were included as search terms to ensure the most common therapies recommended in guidelines were picked up in the search. However, generic terms for therapy were also included to pick up other brands of therapy or therapies sharing features of branded therapies without using the common brand names. The following search terms were used:

depress* (in Title) AND

(Interview* OR case stud* OR observ* OR view* OR experience* OR attitude OR belie* OR feel* OR perce* OR understand* OR opinion* OR interpret* OR “ethnograph*” OR qualitative OR phenomenolog* OR “grounded theory” OR “purposive sampl*” OR “content analysis” OR “thematic analysis” OR “constant compar*” OR “field stud*” OR “theoretical sampl*” OR “discourse analy*” OR “focus group*” OR hermeneutic*OR heidegger* OR colaizzi* OR husserl* OR “narrative analy*” OR “mixed methods”) (in Abstract) AND

(therap* OR psychotherap* OR CBT OR “cognitive behav#ral therapy” OR “Behav#ral Activation” OR “Interpersonal therapy” OR IPT OR “Short-term psychodynamic therapy” OR “Behav#ral Couples therapy” OR “Mindfulness-based cognitive therapy” OR MBCT OR “Cognitive behav#ral treatment”) (in Abstract)

Study selection

Studies were limited to adult, human, English, peer reviewed, academic journal articles only with no date restriction. Screening of titles and abstracts was shared between authors to identify articles likely to be eligible. Full texts of identified studies were reviewed in full to check whether they met the inclusion criteria. Reference lists of eligible articles were searched to identify any additional studies; these were reviewed in full to check for eligibility. The 2009 NICE guideline patient experience chapter and a metasynthesis of experiences of computerised CBT [ 11 ] were examined to identify any additional eligible studies.

Eligibility criteria

Studies were included in which participants were all adults (18+) (studies of adolescents and children were excluded). Participants had to have had depression as a primary diagnosis (bipolar disorder and postnatal depression were excluded and studies where a physical condition or dependency was the primary presentation were also excluded). All studies reported a formal mechanism by which depression was defined for purposes of participant eligibility (studies were not included if participants had self-diagnosed depression). Therefore, studies were required to have employed a diagnostic interview using the Diagnostic and Statistical Manual for Mental Disorders; or to have used a self-report measure that maps onto diagnostic criteria such as the Beck Depression Inventory or Patient Health Questionnaire; or participants had to have been referred for depression treatment by a medical professional. Studies had to report themes concerning the impact of psychological therapy on the participants. Studies had to elicit accounts from participants about their experiences, for example by interviews or focus group (studies only using recorded session material as data were excluded, as were case studies). Studies had to concern experiences of a psychological therapy (studies about psychoeducation only were excluded); therapy could be face-to-face or remote, with a therapist or computerised. Studies were included if some or all participants were known to be taking antidepressant medication; however, the focus of the study had to be on patient experiences of psychological therapy. Participants should have experienced the therapy (studies were excluded where participants were asked about hypothetical ideas of therapy).

Quality appraisal

Each article was assessed following guidance provided by the Critical Appraisal Skill Programme tool [ 17 ] which provides prompts to consider of the quality of each article [ 18 ]. The tool is not used to provide an absolute score of quality but facilitates consideration of clarity of aims, appropriateness of methods, design and recruitment methods, suitability of data collection, researcher reflexivity, ethics, analytic rigour and clarity of findings.

Data extraction and synthesis

Key information was extracted from each article concerning participants and methods. The variables of interest were discussed and agreed by all authors and set out in an Excel spreadsheet into which details for each study were extracted by one author and checked by another (see Tables 1 , 2 and 3 ). All articles were then entered into NVIVO for analysis. Following the principles of inductive thematic analysis [ 55 ], the first and second authors read articles in full, allocating codes to salient features of the data. Following Sandelowski and Barroso [ 12 ], content coded were study findings ; raw data from study participants were not included in the coding process. “Findings consist of the databased and integrated discoveries, judgments, and/or pronouncements researchers offer about the phenomena, events, or cases under investigation. Findings are researchers’ interpretations of the data they collected or generated in their studies.” [ 12 ] p142. The use of author interpretations only as data for this metasynthesis avoids potential bias which could arise from attempting to re-analyse primary data selectively presented as participant quotes in the original studies.

All relevant author interpretations were coded where they concerned the experience or impact of therapy. Interpretations that related only to pre-therapy experiences of depression or pre-therapy expectations were not included unless they related directly to experiences of therapy in some way. Two authors coded five articles independently and then discussed the process of coding and nature of code labels to ensure an overall consistent approach. They then coded the remaining articles independently. When all articles were fully coded, the first author checked coding of all articles for consistency and undertook merging and renaming of codes for consistency and accuracy, following the principles of thematic analysis [ 55 ]. A final list of codes was then sorted into a set overarching themes and sub themes which were then discussed among all three authors and refined.

Using the attribute tool in NVIVO, each study was allocated to a model of therapy. These were categorised broadly as either those focussing on cognitions and behaviours (CB; including CBT, schema therapy, MBCT and solution focused models) or those focusing on attachments and relating (AR; including psychodynamic, narrative, systemic and counselling). Some studies included both CB and AR approaches (see Tables 1 , 2 and 3 for study classifications). Therapies were also categorised by delivery style (face-to-face or remote) and a delivery format (group or individual). Crosstab queries were used to assess whether certain codes appeared across all types of therapy or if there were some codes which were specific to certain types of therapy or delivery. Since the therapy models and format were not equally represented, this was not a quantitative frequency exercise but was used only to gain a qualitative sense of the representation of codes among certain models or formats. Frequencies are therefore not presented as this would be misleading, but within each theme we comment qualitatively on any particular issues of representativeness across the set of studies.

The initial search identified 2404 studies. A total of 116 articles were reviewed in full, including 21 identified from other sources (reference searches and other reviews). Of these, 38 articles representing 37 studies met the eligibility criteria (see Fig. 1 ).

Prisma Flowchart

Included studies

Tables 1 , 2 and 3 present the key features of the 37 studies included. Studies include a wide range of therapy models delivered in various formats including face-to-face, online and telephone plus group and individual therapies. Studies had been carried out in the UK and Europe as well as the US, South America and Hong Kong. While the majority of participants across the studies were white females (see Tables 1 , 2 and 3 ), there were also a significant proportion of men represented as well as participants from diverse ethnicities including Chinese, Hmong, Black, Hispanic and Iranian. Some studies included participants who were in a position of economic disadvantage. The age of participants ranged from 18 to 88 and the total number of participants represented is 671. Qualitative data were collected at varying time points including during therapy, at end-of-treatment and at various later points up to 4 years post-therapy.

Qualitative methods used among the studies included thematic analysis, grounded theory, framework, template analysis, holistic processing of linguistic complexity, (inductive) content analysis, interpretative phenomenological analysis or a generic phenomenological approach, systemic text condensation, constant comparison and hermeneutic circle approach.

There has been an ongoing discussion on the use of quality criteria for qualitative research in terms of whether articles of poorer quality should be included in meta-syntheses [ 56 ]. For the purpose of the current review, all identified articles were included since the eligibility criteria for inclusion in the review ensured that all included studies already met required parameters of suitability of method and design. The only element of the Critical Appraisal Skills Programme (CASP) tool where there was more variability in quality was the rigour of data analysis in that some studies produced more descriptive or superficial analysis while others were more in depth. Nevertheless, all provided some valuable insights (or ‘findings’) on patients’ experiences and so were included. The relatively small sample sizes characteristic of qualitative research are partly mitigated by combining the samples and findings in metasynthesis. Specifically, while some studies had relatively small homogenous sample sizes in keeping with the chosen methodology, the combined sample of 671 represents relative ethnic, gender and age diversity (see Tables 1 , 2 and 3 ). Further, where authors may have an explicit or implicit bias towards a specific treatment modality, this is partly mitigated in review in that the three current authors are independent of all of the studies and treatment modalities. Specifically concerning potential bias of the current reviewers, the first and second authors are healthcare researchers not trained or practicing in any form of psychological therapy. The third author is a trainee clinical psychologist currently training in a range of different psychological therapies with no particular affiliation to one modality.

Three main themes are detailed below beginning with the role of therapy features and setting; therapy processes and how they impact on outcomes; and therapy outcomes (benefits and limitations). Sub themes are reported within these main themes below. As noted above, all quotes provided to illustrate the themes are author interpretations - no primary data is presented.

The role of therapy features and setting

In addition to the therapy model and delivery format and style, study findings suggested that a range of other features of therapy may impact on patients’ experiences. Specifically, aspects of the therapy environment and structure could impact in certain ways. For example, in a day treatment programme which provided a mixture of group and face-to-face therapies on an intensive basis, participants appeared to feel they benefitted significantly from a regular daily routine.

The possibility of being able to spend all day in the unit and the regular daily routine was seen as particularly positive and was reported to facilitate personal activity [ 53 ].

In group formats, it appeared that the group size could impact on the usefulness of the group with smaller groups facilitating discussion better.

Some felt it was easier to concentrate and more relaxing when the group was split into two for specific discussions [ 41 ].

Across all types of therapy, delivery format and style, place and environment appeared to be important. This ranged from issues around privacy of the clinic setting and physical spaces, the peace and tranquillity of the therapy room to physical access issues including transport which could create more or less stress prior to arriving at therapy.

In the DIT studies, the time limited nature of the intervention relative to traditional psychodynamic psychotherapy appeared to be experienced as useful to help with focusing on the most relevant or important issues but also appeared to generate anxiety around the brevity of time and the wish to get as much out of the sessions as possible [ 45 ].

In a number of studies of online individual CB approaches, participants were reported as expressing willingness to try novel approaches and technologies and this was reported to be a factor in participants’ experiences of the online format.

In comparison to traditional remedies participants reported treatment as a new, exciting and better way of receiving care [ 22 ].

Another key element of therapy features which could impact on experience related to accessibility of therapy versus regularity. This is particularly relevant to considering the benefits of remote therapies versus face-to-face therapies. The enhanced accessibility of remote therapy appeared to be highly valued by participants receiving individual online CB therapy. However, in contrast, frustration with technological difficulties was a common finding in studies of individual online therapies.

Someone thought that the technology worked perfectly while most had some kind of technical problems … . Several described the importance of the smoothly working technology since depression means low tolerance for adversity [ 32 ].

As a contrast to this, having regular reliable contact with a therapist face-to-face appeared to be valued, for example in individual psychodynamic therapy and counselling in which the consistent timing of the therapy slots may be part of the theory of change within the model.

The counsellor is seen as a consistent and containing support with whom clients can feel safe [ 43 ].

There were a number of ways in which the therapy setting or features appeared to either exacerbate or help prevent patients feeling stigmatised by their participation. The nature or branding of an intervention, for example, was reported to reduce the felt sense of stigma. The ‘Happiness programme’ [ 51 ] is an example of how simple labelling could destigmatise an intervention. Studies of face-to-face individual CB therapies found that people experienced a sense of stigma from engaging in therapy whereas those receiving remote individual CB therapy appeared to feel that their privacy was enhanced and stigma therefore reduced. At the same time this only applied where individuals had a private computer they could use and the requirement for an internet linked computer could limit privacy if for example it was necessary to use a computer in a more public or even family space.

The minority who accessed online CBT in other settings ( e.g. used a relative’s computer) found it harder to engage with the therapy, due to concerns about privacy and being interrupted [ 21 ].

Therapy processes and how they impact on outcomes

Therapy processes: what works.

A common feature of all therapeutic modalities and modes of delivery was that therapy appeared to help through certain processes including through enabling sharing and talking about feelings to others (in a group or just to the therapist); and providing a valuable space to talk about one’s feelings. A key process commonly referred to was of participants gaining new insights to help reframe emotions, problems or to increase awareness and also helping to identify existing coping mechanisms. New insights were applied in order to manage feelings and also later on after therapy to help prevent relapse.

..treatment had encouraged them to revise their perceptions of depression and of themselves. They seemed to have gained a greater understanding of themselves and their current situation by working with the material and expressed that they had acquired specific insights to help them cope with their depression [ 22 ].

Women explained that the sessions helped show how the patterns from childhood were still setting them up for misery in their relationships today. This was strengthened by the ability to recognize their emotions and that, rather than staying the same forever, negative feelings do pass. This gave them a valuable sense of hope and assurance [ 31 ].

The meaning of the symptoms changed. They did not threaten her sense of self anymore, because she could understand them better [ 54 ].

Face-to-face group therapies appeared to have some specific features that were useful. Group membership was reported to facilitate upwards or downwards comparison with others, helping to put one’s own difficulties in perspective; group membership was also reported to provide social support and groups were reported to provide a sense of comfort through sharing similar experiences.

For several people this seemed to be an important normalising process. Themes such as being understood by the group, realising that you were not alone and being able to show emotion in a safe environment, emerged as common positive aspect to being in a group [ 27 ].

In studies on group interventions, studies found that it was important to be able to trust other group members. Groups could also be useful through members learning how others apply certain techniques.

A narrative group for Hmong people based on cultural theory appeared to be particularly valued for the additional social activities involved [ 57 ]; while multi-systemic family groups were reportedly valued for their involvement of one’s own family in treatment.

They experienced the self-disclosure of their own family members, in particular of their children, or of other group members as helpful … They also reported that it was helpful that their family members were able to discuss different issues … patients benefited that their children gained a better understanding of the depression [ 44 ].

Across both CB and AR approaches, studies found that behavioural changes inspired by therapy were felt to directly activate improvements in mood; and that take-home materials of a wide variety were felt to be useful for ongoing work between therapy sessions. While this finding dominated studies of CB approaches in which take-home materials are a common feature, this also applied for example to DIT in reference to the ‘end-of-therapy’ letter which ‘helped the digestion of the therapeutic material after therapy had ended’ [ 45 ]. In individual CB approaches, in-between session work appeared to be experienced as a valuable part of the therapeutic process. In face-to-face CB approaches, studies found that the techniques for managing feelings could become naturalized and automatic and this was a key part of the process.

It was only when these individuals were asked how they managed a “low day” that it was evident that they were unconsciously or automatically using CBT skills [ 28 ].

Across all face-to-face types of therapy, learning the importance of focusing on one’s self was described as a key process. All face-to-face individual therapies found that participants experienced being enabled to process the past. Likewise individual therapies seemed to enable people to learn to reflect on their problems. Face-to-face therapies were reported to help through impacting on causal attributions about depression.

This was achieved through a reconceptualisation of the aetiology of their problems, which in many cases involves the convergence of factors belonging to multiple areas [ 50 ].

Therapy processes: what’s unhelpful

This sub-theme concerns aspects of therapy that were seen as unhelpful, which varied by type of therapy. Across CB and AR approaches, studies found that therapy could emphasise or confirm problems and that some participants could experience interaction with the therapist as difficult; sometimes participants reported blaming themselves for non-improvement. In group approaches, there were findings suggesting that too much time was sometimes spent sharing instead of focusing on issues.

Unhelpful aspects specific to CB approaches included doubting the usefulness of homework and finding the initial formulation too difficult to understand. With online CBT (therapy by email), it was found that typed exchanges between patients and the therapist could be felt as awkward and cause unwelcome time delays. In face-to-face group CB therapies, group members’ negative emotions could be experienced as overwhelming.

A number of participants mentioned that they were overwhelmed by the emotions displayed by others in the group, particularly in the early stage of the group process [ 42 ].

The requirement to practice or do homework in CB approaches was sometimes found to be burdensome; participants could feel overwhelmed by the techniques they had to learn to use; and the volume of material and information could feel excessive.

Each session brought a new practice and practices were seldom revisited in the curriculum … the number of options to choose from for home practice seemed to be confusing to participants [ 38 ].

Specifically in MBCT, the practice of the “body scan” was reported to trigger flashbacks or severe anxiety for some participants with a history of abuse or trauma [ 27 ]. In a study of public psychotherapy for economically disadvantaged Chileans and Colombians, it was found that therapy could sometimes feel unfocused and unclear [ 50 ]. Two studies, one with Hmong people and one with older white Americans found that therapy was felt to ignore spirituality [ 49 , 57 ].

Issues integrating therapy with real life

This sub theme concerns the inter-relationship between therapy and ongoing daily life. These issues were raised across all forms of therapy and modes of delivery although appeared much less relevant to AR approaches because most of the issues raised relate mainly to the use of specific techniques taught within CB approaches for managing everyday thoughts and feelings. Several studies across CB approaches found that even where participants found the ideas, concepts and practical aspects of the techniques taught in these therapies useful in principle, they struggled to apply them in real life.

… the training did not work because it was too ‘artificial’ and too far from real-life issues [ 40 ].

Studies also found that participants reported certain practical barriers to maintaining practice of these techniques such as not having time or a quiet space at home.

… implementing cognitive strategies as suggested in therapy was simply not practicable given the time and circumstances. Sarah, for example, sometimes felt she did not have the quiet and space to ‘stop and think’ because she lived in cramped accommodation with her mother [ 16 ].

Some findings did however indicate that some participants felt able to overcome these barriers.

One woman felt that making the time to practice the longer meditation was ‘too much of a luxury’ when she had 6 children at home and instead practiced mindfulness of washing the dishes and mindful walking … Others adopted a more flexible attitude towards practice [ 27 ].

Specific to face-to-face CB approaches, it was reported that some participants were able to build some of the techniques they had learnt into their life and lifestyle and were then able to benefit from them.

She was doing a lot of informal practice, for example while driving, chopping vegetables, or gardening [ 39 ].

Although most standard therapies do not provide for the therapist to get involved with the clients’ problems of living, thus creating a separation of social and psychological issues, one study of an AR approach found that among Hmong women living in the USA, therapists providing practical support with issues of living was seen as key to establishing a therapeutic relationship.

Group facilitators, acting as advocates in these areas and helping the women to connect to useful resources, seemed to increase the legitimacy and trust the women placed in the group therapy experience [ 57 ].

Patient preferences and individual difference

This sub theme concerns patient preferences for certain styles of therapy and individual differences which impact on the experience of therapy. Across all modes of therapy was the finding that therapy expectations can impact on therapy outcome in a number of ways. For example, people with positive expectations might be more motivated to work in therapy.

They also explained how their increased expectation of treatments made them completely motivated to be more active and productive during the interventions [ 26 ].

Among CB approaches, findings suggested that choice of therapeutic model and content should be based on the individual or tailored to their needs. It was also claimed that patient preference could impact on engagement and therapy satisfaction in CB approaches.

… those patients who reported negative views of cCBT [computerised CBT] said they deliberately did not use the programme after the initial attempts, indicating poor engagement due to deliberate nonadherence [ 34 ].

One such preference that might be taken account of is whether people wish to focus on issues of the present or the past and this preference might lend itself to different models or approaches within a model. Further, specific to CB approaches, findings suggested that some standardised content is not always felt as relevant to individuals and should be tailored. Across all approaches it appeared that different people may find different aspects and elements helpful. For example, people might prefer different techniques to others, some people might appreciate online communication and others might find it frustrating. Some studies found individual differences so fundamental that they grouped participants. For example a study on remote CBT [ 22 ] grouped participants into ‘strivers’, ‘readers’ and ‘doers’ reflecting their different approaches to interacting with the online programme.

It was also reported that people’s expectations around therapy could influence their levels of engagement in CB approaches and therefore have a positive or negative impact. Some studies found that there were varying degrees of willingness among participants to invest time in practicing CB techniques and this impacted on therapy effectiveness. Techniques and tools were also often adapted by individuals to suit their lifestyle or way of doing things.

It was evident that the proposed approaches and techniques were not universally suitable, and some patients went to considerable lengths to restructure the content to suit their perceived needs [ 35 ].

Challenges of undertaking therapy

This sub theme concerns findings across several studies which indicate the sorts of challenges people appear to experience when undertaking therapy. Confronting painful emotions in therapy was reported to be a particular challenge across all therapy models and delivery formats.

During the course of their treatment, they had discovered aspects of themselves which they felt unhappy about – for example, realizing that they had social anxiety … or had needed to revisit difficult periods of their lives and thus painful memories [ 20 ].

It was also found that people could experience talking about one’s self and sharing emotions as very difficult and this was common across face-to-face therapy model.

Group psychotherapy patients typically experienced difficulties sharing their problems with the group. They could see their own problems as minor or ‘censor themselves,’ as not everything seemed permissible [ 47 ].

Studies found that although people might recognise the need to change their thinking or behaviour, this was felt to be very hard to do. Again this was common to all main face-to-face models.

Participants described not being able to break familiar well-rehearsed patterns and responses with family members. Terry talked about always in the past finding his family too smart for him, and even now when he went home he was immediately drawn into the familiar role of being ‘pushed aside’ [ 16 ].

Nevertheless, some studies found that participants recognised the benefits of working through challenging aspects of therapy and some studies also found that people were prepared to make more effort even when they found that they were not yet seeing any improvements resulting from therapy.

Failing to improve from treatment made participants express a wish of going back and working more with the material hoping to profit from it [ 22 ].

Importance of the therapist

The importance of the therapist to the experience of therapy was a key theme across many studies. Some aspects of this theme were specific to the difference between remote and face-to-face therapy. In remote CBT for example, lack of therapist support was found to relate to dropout or poor engagement.

The perception of not being taken seriously, as being one in a pile of depressed individuals offered a panacea, led to little confidence in iCBT [internet CBT] [ 32 ].

It was also found that in remote CB approaches, genuine interaction was felt to be a key missing ingredient, that it was not possible to “establish a meaningful therapeutic relationship online” [ 21 ] and that the lack of therapist support was felt to reduce the impact of therapy.

To some extent this limitation could be mitigated through interactive or live support aspects and it was found that these elements were essential to mitigate the lack of a therapist.

The relationship with the therapist had a function beyond supporting MoodGYM use, in providing an arena for sharing thoughts and feelings and receiving feedback and advice [ 35 ].

There remained a strong sense from study findings that face-to-face interaction with a therapist could improve the experience of therapy and patient satisfaction. Thus, face-to-face therapy was depicted as a collaboration between the patient and therapist and the therapist was described as key to facilitating new insights and skills development. In specific cross-cultural settings, the therapist also appeared to be seen as being able to facilitate cultural adaptation to the nature of therapy given that the individual problem focus of Western therapy does not naturally fit with some other cultural perspectives on emotional problems. Given the central role of the therapist, a good relationship with the therapist was found to be particularly important to patients in individual therapy. It was also reported as being important to participants that they felt understood by their therapist and that the therapist displayed empathy and other positive characteristics such as being accepting, non-judgemental, reassuring, normalising, caring, respectful, soothing, calming, professional, kind, warm and compassionate. In particular, studies of individual face-to-face therapy found people placed high value on the therapist listening, understanding and working collaboratively.

… there was a sense of the counsellor listening with understanding. This was felt to be purposeful listening to ascertain clients’ emotions and the personal meanings attributed to what they were discussing in their sessions [ 43 ].

Therapy outcomes (benefits and limitations)

Benefits of therapy.

A range of benefits of therapy were identified which featured across all therapy models, formats and delivery types. These were that therapy was reported to improve symptoms; enable people to change or improve their way of relating to others; and empower people. An additional benefit which featured in the majority of studies was that therapy was felt to enable participants to use techniques learnt in therapy to manage their everyday thoughts and feelings.

… participants spoke of using this strategy during stressful situations such as entering a crowded room. In the accounts of half the participants intentionally refocusing attention was associated with a positive impact on depression-related mood and thinking [ 19 ].

Further benefits found across all face-to-face models were that therapy was felt to enable lifestyle or behaviour changes; and improve self-knowledge, self-belief or self-acceptance.

Participants reported rediscovering lost identities and realized that difficult feelings pass. Additionally, participants were able to think more clearly and become more confident and self-accepting [ 33 ].

CB approaches of varying formats were found to provide techniques to help prevent relapse. Specific to face-to-face CB models, therapy was found to help break habitual thinking or behaviours; and specific to individual face-to-face CB approaches, therapy was reported to benefit even if people had negative expectations or experiences. In a study of PST for older people, therapy was found to also have an impact on participants’ memory [ 49 ].

Limits to therapy

This sub theme concerns the sense that whatever value or benefits therapy can bring, there are inevitably limits to what can be achieved in therapy. In particular, findings indicated that therapy irrespective of model, was often reported to leave family, social or health problems unresolved, perhaps through the focus on individual psychological problems and the disconnect people often feel between therapy and situations they face in real life noted earlier.

Interviewees saw their problems as being related to their situational conditions, for instance marriage problems, conflicts in a job, interrupted studies or economical difficulties. Even though they felt that psychotherapy and the therapist were giving valuable support in a difficult situation, they felt that solutions were not found for the acute problems [ 54 ].

Studies also found that participants often considered therapy as only one part of a wider process required to live a better life and that therapy was not felt to have all the answers.

Participants viewed CBT as part of a process of self-improvement that began before therapy and contained other change elements, like giving up smoking … and drinking [ 16 ].

Specifically relating to individual face-to-face CB approaches, it was found that people could be left feeling as though they had not had the chance to explore the underlying causes of their depression properly. This and other factors meant that people appeared to be left feeling they had missed out on potential benefits from therapy and a common finding was that participants expressed a wish for more therapy or a different type of therapy.

While most of the group found the course enjoyable the majority of the group thought the course was too short [ 27 ].

The lack of depth could be perceived as due to lack of time because of finite sessions, or as something fundamental to the model of CBT itself [ 20 ].

After therapy ends

This sub theme describes a range of findings relating to how people feel after therapy has ended. Therapy was reported to provide a number of benefits during and after therapy, described earlier. Such positive experiences, particularly in group CB approaches, were found to encourage ongoing practice after ending. However, studies also reported a range of negative experiences after therapy had ended. Some CB studies found that participants reported losing motivation to practice techniques once therapy had ended.

These individuals mentioned that they tended to repeat the techniques they had learned from the interventions, but as soon the interventions ended they lost their motivation [ 26 ].

In all therapy models, it was found that ending therapy could be experienced as a loss.

This group also described the difficulty of treatment ending, with many participants in the group described feeling lost, suggesting that they still continued to rely on their therapist for help in the management of their depression and had not gained the same sense of self-dependency or sense of control [ 28 ].

Similarly, two studies both involving group face-to-face therapy [ 25 , 53 ] found that people could find themselves feeling more alone after therapy had ended.

Some patients reported feelings of loneliness after discharge as the close relationships with the unit’s other patients had ceased with the end of treatment [ 53 ].

Related to the above indications that ending therapy led to loss of motivation, a sense of loss and feeling more alone, it appeared that irrespective of therapy modality, symptoms were reported to persist or relapse among some participants after therapy .

The review findings highlight a range of ways in which certain types or formats of psychotherapies can be experienced by people with depression in terms of the processes that may relate to benefits as well as harms that arise. The findings emphasise that there are a number of important common factors across psychological therapies which can impact on patients’ experiences of therapy and outcomes. The discussion below considers some of the key common factors highlighted in relation to related literature and also considers issues arising in relation to negative effects of psychological therapies.

Some of the factors common to psychological therapies highlighted in this review have been identified in quantitative common factors research such as the importance of setting and the role of the therapist. There is, for example, extensive evidence that the therapeutic relationship is central to therapy process and outcomes [ 58 ] and that specifically, therapeutic alliance, the most researched element, has an effect size (Cohen’s d) of 0.58 in meta-analysis [ 59 ]. Similarly, a metasynthesis of patient experiences of computerised therapy for anxiety and depression emphasised the role of common factors across different formats of computerised delivery [ 11 ]. However, the current review findings emphasise the significant limitations of remote therapies in which key common factors are removed. Specifically, findings illustrate clearly why many people who receive remote therapies in which the therapist is replaced by a computer programme, feel left wanting something more, in the absence of genuine interaction with a therapist. Similar to findings from the above metasynthesis of experiences of computerised therapy, the limitations of remote therapies may be partly mitigated by sensitivity of the remote therapy to individuals’ sense of self, taking into account differing individual needs, preferences and the impact of an individual’s symptoms on their ability to engage with remote delivery.

Less evident from quantitative research is the role of stigma and, specifically, how stigma impacts on willingness to engage in psychological therapy. In particular, the review findings illustrate how, in spite of the limitations around lack of therapist interaction, remote forms of therapy can go some way to addressing stigma through creating the possibility of privacy. Similarly the metasynthesis of patient experiences of computerised therapy for anxiety or depression [ 11 ] indicated that it can be empowering to self-tailor therapy delivered in a computerised format; but in the absence of a therapist, this may be burdensome, requiring motivation and self-discipline. The current review suggests that alternative means of reducing stigma are also feasible without necessarily removing the therapist or the physical setting. For example, simple changes such as therapy name and location can reduce the shame of coming forward for help. Regular attendance at a non-stigmatising setting can then reduce shame further by enabling face-to-face sharing of experience and information with others.

Also less evident from quantitative research is the limited relevance of psychological models and techniques to individual life contexts and their inability to help clients with their immediate family or social problems that may be triggering or maintaining depressive experiences. This finding came up often among several forms of therapy. It is not a finding that would be identified within most psychological therapy trials because the focus tends to be on symptom outcomes. In an overview of targets and outcomes in psychotherapy research [ 60 ], only one meta-analysis was identified which reviewed quality of life outcomes in trials of psychotherapy for depression. The meta-analysis referred to [ 61 ] found only 44 RCTs of psychotherapy for depression (a minority of depression RCTs published) reporting a quality of life or functioning outcome. Moreover, while some quality of life measures may ask about issues relating to social support and relationships, many focus on individual functioning or health and may not reflect patient priorities [ 62 ]. The findings in the present review concerning social and cultural contexts lend support to calls for a greater focus on non-symptom outcomes and specifically for outcomes to be patient-focused and patient defined: “Patients are the ones who suffer from mental disorders and, as long as we do not exactly know what these disorders are or what their causes may be, we should rely on the ones who suffer from them to decide what outcomes should have the priority” [ 60 ]. This may also then lead to greater recognition of the extent to which psychological therapies have become defined by individualistic Western epistemologies which place responsibility on patients to change their ways of thinking and doing with little consideration of the social contexts in which these changes are expected to take place [ 63 ].

The studies in this review which focus on specific ethnic groups or economically disadvantaged groups highlight this particularly well, in that it where the therapy model stepped outside of the traditional boundary and enabled therapists to help with practical issues, this was felt by participants to help enhance the therapeutic relationship and subsequently improve outcomes. Review findings also suggest that group psychotherapies have the potential to cross some of the bridges between individual psychology and social factors. Findings indicated that factors common to groups such as the social element, opportunity to relate, share and compare experiences with others cut across models and enable social development. In some cases this also provided direct social connection where groups could cross the therapeutic boundary and undertake social activities together.

The findings of the present metasynthesis also highlight the importance of considering adverse effects of psychological therapies. These have historically been under-researched in the field and although there has been increasing recognition of the potential for and incidence of adverse effects, they remain under-assessed in clinical trials [ 64 ]. While it might be inevitable that some individuals experience therapy as challenging or even unhelpful, there are also findings that reveal the potential for harm, such as reports of finding other group members’ emotions overwhelming; finding practicing certain techniques overwhelming; or finding that the Bodyscan can generate flashbacks. The finding concerning groups is in line with a review of adverse outcomes in group psychotherapies which set out a range of therapist and patient factors that could precipitate negative effects. This review noted that “highly charged” disclosures from some group members can be experienced as overwhelming by other group members and that this may happen in the early stages of a group before it has developed into a “supportive unit” [ 65 ]. In spite of this review published two decades ago, there remains limited development in methodologies to monitor such negative effects. A recent review of instruments to monitor negative effects found nine available instruments including one specifically for group psychotherapy published in German [ 64 ]. The authors found these measures to be inadequately validated and recommended that work was needed to develop a comprehensive consensus framework which could be used in routine outcome monitoring and research. The findings of the present metasynthesis support the call for such measures but it is also important to highlight that the parameters of any measure should not be designed by researchers alone but should also take into account the first person perspectives of patients which may highlight previously unseen harms or illustrate the ways in which certain processes can lead to harm for some individuals.

Limitations

Although the review presented provides a comprehensive look at the literature in this field and includes a large number of studies, it is also important to acknowledge that some therapies are under-represented or absent while other therapies dominate i.e. CBT and MBCT. It is important not to conflate absence of knowledge with knowledge of absence which the paradigm of evidence based practice has a tendency towards, so that particular treatments are assumed to be ineffective because of an absence of research rather than research showing negative findings. It is likely that a wider range of experiences have been found among the participants of the CBT and MBCT studies merely because there are more studies of these treatments. Many of the experiences identified in these studies may apply equally to other forms of therapy without yet having data to support this. Where certain findings by their nature appear to relate to specific elements of branded therapies (e.g. Bodyscan), or specifically to group, individual, remote or face-to-face formats, these findings may be considered to reliably differentiate. However, where findings do not have a high degree of specificity to a particular model or delivery mode, caution is required around whether the findings have specificity to the model within which the finding arose.

Another limitation concerns diversity. As noted earlier, by combining the studies, a relatively good degree of diversity is represented among the combined population of participants. However, the non-White populations represented are fairly specific: Iranians, Chinese, African Americans, Chileans, Columbians and Hmong women. Because many of these studies are specifically addressing cultural and ethnic issues, they can be particularly informative about the role of culture in more depth than is possible within RCTs. The range of ethnicities and cultural groups remains relatively limited however. In terms of informing guideline development, NICE, for example, explicitly sought to give special consideration to people from black and minority ethnic groups [ 66 ]. While the findings from this review could be used towards this aim, it would be useful if future research exploring patient experiences of psychological treatments for depression ensured greater representation of UK black and ethnic minority and other underrepresented UK populations in order to inform NICE guidelines.

Another limitation is the diversity of ways in which studies classified depression for purposes of eligibility. The review excluded studies in which participants self-diagnosed depression thereby ensuring some formal criteria were met. While referrer diagnosis (usually done by primary care professionals), formal psychiatric diagnostic interviews and self-report questionnaires have been designed or developed with a view to being equally reliable, there are inevitable differences in degree of reliability between these forms of diagnosis in practice.

Meta-analyses of psychological therapies for depression indicate that several forms of psychotherapy can be effective for reducing symptoms. However, as Cuijpers argues, much of this evidence is potentially subject to publication bias, poor quality, researcher allegiance, lack of long-term follow-up and overestimated effects [ 67 ]. Moreover, since trial outcomes tend to be determined by the interests of researchers, practitioners, employers, insurance companies or policymakers rather than patients, it is critical to understand in more depth what therapies are like for those who receive them and to use these findings to improve practice and delivery of therapies. There are significant limitations of psychological therapies as currently configured in UK, US and Europe, particularly in that they are often offered on a short term basis only, that they tend to be restricted to certain theoretical models and that their outcomes have been assessed only in terms of symptoms rather than patient preferred outcomes. It would benefit the field to look at the sorts of cross-model issues identified in the findings in this review in order to improve therapy impact and to include more orientation to social factors.

Findings of this review emphasise that not only should patients be more fully involved in discussions and decisions about which therapies they might be offered, but also in conversations about tailoring therapy to individual needs both before and during therapy. These sorts of discussions should be informed by much clearer information about therapy types and formats and it would be useful for a co-produced patient guideline to be developed which provides clear information based on evidence which might enable patients to make informed choices and engage on equal terms in discussions with their referrer. Therapy providers could also consider taking a more patient centred approach to developing their models, taking into account common factors which patients regard as important, engaging with the well-established field of research which indicates that these are significant predictors of outcome [ 58 ].

Availability of data and materials

Data sharing is not applicable to this article as no datasets were generated or analysed during the current study. The current study drew on and reviewed data already published; all published studies drawn on are cited in the Table and References.

Abbreviations

Therapies focusing on attachments and relating

Behavioural Activation

Critical Appraisal Skills Programme

Therapies focusing on cognitions and behaviour

Cognitive Behavioural Therapy

Dynamic Interpersonal Therapy

European Psychiatric Association

European Union

Interpersonal Therapy

Long-term Psychodynamic Psychotherapy

Mindfulness Based Compassionate Living

Mindfulness Based Cognitive Therapy

Metacognitive Therapy

National Institute of Clinical and Health and Care Excellence

Psychodynamic Psychotherapy

Problem Solving Therapy

Randomised Controlled Trial

Short-term Solution-Focused Therapy

Supportive Therapy

Short Term Psychoanalytic Psychotherapy

United Kingdom

United States of America

World Health Organisation

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McPherson, S., Wicks, C. & Tercelli, I. Patient experiences of psychological therapy for depression: a qualitative metasynthesis. BMC Psychiatry 20 , 313 (2020). https://doi.org/10.1186/s12888-020-02682-1

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Substance-related disorders

Mood Disorders

Research in mood disorders can help understand their causes and improve treatment methods. Here are a few ideas to get you started.

The impact of genetics on the susceptibility to depression
Efficacy of antidepressants vs. cognitive behavioural therapy
The role of gut microbiota in mood regulation
Cultural variations in the experience and diagnosis of bipolar disorder
Seasonal Affective Disorder: Environmental factors and treatment
The link between depression and chronic illnesses
Exercise as an adjunct treatment for mood disorders
Hormonal changes and mood swings in postpartum women
Stigma around mood disorders in the workplace
Suicidal tendencies among patients with severe mood disorders

Anxiety Disorders

Research topics in this category can potentially explore the triggers, coping mechanisms, or treatment efficacy for anxiety disorders.

The relationship between social media and anxiety
Exposure therapy effectiveness in treating phobias
Generalised Anxiety Disorder in children: Early signs and interventions
The role of mindfulness in treating anxiety
Genetics and heritability of anxiety disorders
The link between anxiety disorders and heart disease
Anxiety prevalence in LGBTQ+ communities
Caffeine consumption and its impact on anxiety levels
The economic cost of untreated anxiety disorders
Virtual Reality as a treatment method for anxiety disorders

Psychotic Disorders

Within this space, your research topic could potentially aim to investigate the underlying factors and treatment possibilities for psychotic disorders.

Early signs and interventions in adolescent psychosis
Brain imaging techniques for diagnosing psychotic disorders
The efficacy of antipsychotic medication
The role of family history in psychotic disorders
Misdiagnosis and delayed treatment of psychotic disorders
Co-morbidity of psychotic and mood disorders
The relationship between substance abuse and psychotic disorders
Art therapy as a treatment for schizophrenia
Public perception and stigma around psychotic disorders
Hospital vs. community-based care for psychotic disorders

Research Topic Kickstarter - Need Help Finding A Research Topic?

Personality Disorders

Research topics within in this area could delve into the identification, management, and social implications of personality disorders.

Long-term outcomes of borderline personality disorder
Antisocial personality disorder and criminal behaviour
The role of early life experiences in developing personality disorders
Narcissistic personality disorder in corporate leaders
Gender differences in personality disorders
Diagnosis challenges for Cluster A personality disorders
Emotional intelligence and its role in treating personality disorders
Psychotherapy methods for treating personality disorders
Personality disorders in the elderly population
Stigma and misconceptions about personality disorders

Obsessive-Compulsive Disorders

Within this space, research topics could focus on the causes, symptoms, or treatment of disorders like OCD and hoarding.

OCD and its relationship with anxiety disorders
Cognitive mechanisms behind hoarding behaviour
Deep Brain Stimulation as a treatment for severe OCD
The impact of OCD on academic performance in students
Role of family and social networks in treating OCD
Alternative treatments for hoarding disorder
Childhood onset OCD: Diagnosis and treatment
OCD and religious obsessions
The impact of OCD on family dynamics
Body Dysmorphic Disorder: Causes and treatment

Post-Traumatic Stress Disorder (PTSD)

Research topics in this area could explore the triggers, symptoms, and treatments for PTSD. Here are some thought starters to get you moving.

PTSD in military veterans: Coping mechanisms and treatment
Childhood trauma and adult onset PTSD
Eye Movement Desensitisation and Reprocessing (EMDR) efficacy
Role of emotional support animals in treating PTSD
Gender differences in PTSD occurrence and treatment
Effectiveness of group therapy for PTSD patients
PTSD and substance abuse: A dual diagnosis
First responders and rates of PTSD
Domestic violence as a cause of PTSD
The neurobiology of PTSD

Free Webinar: How To Find A Dissertation Research Topic

Neurodevelopmental Disorders

This category of mental health aims to better understand disorders like Autism and ADHD and their impact on day-to-day life.

Early diagnosis and interventions for Autism Spectrum Disorder
ADHD medication and its impact on academic performance
Parental coping strategies for children with neurodevelopmental disorders
Autism and gender: Diagnosis disparities
The role of diet in managing ADHD symptoms
Neurodevelopmental disorders in the criminal justice system
Genetic factors influencing Autism
ADHD and its relationship with sleep disorders
Educational adaptations for children with neurodevelopmental disorders
Neurodevelopmental disorders and stigma in schools

Eating Disorders

Research topics within this space can explore the psychological, social, and biological aspects of eating disorders.

The role of social media in promoting eating disorders
Family dynamics and their impact on anorexia
Biological basis of binge-eating disorder
Treatment outcomes for bulimia nervosa
Eating disorders in athletes
Media portrayal of body image and its impact
Eating disorders and gender: Are men underdiagnosed?
Cultural variations in eating disorders
The relationship between obesity and eating disorders
Eating disorders in the LGBTQ+ community

Substance-Related Disorders

Research topics in this category can focus on addiction mechanisms, treatment options, and social implications.

Efficacy of rehabilitation centres for alcohol addiction
The role of genetics in substance abuse
Substance abuse and its impact on family dynamics
Prescription drug abuse among the elderly
Legalisation of marijuana and its impact on substance abuse rates
Alcoholism and its relationship with liver diseases
Opioid crisis: Causes and solutions
Substance abuse education in schools: Is it effective?
Harm reduction strategies for drug abuse
Co-occurring mental health disorders in substance abusers

Choosing A Research Topic

These research topic ideas we’ve covered here serve as thought starters to help you explore different areas within mental health. They are intentionally very broad and open-ended. By engaging with the currently literature in your field of interest, you’ll be able to narrow down your focus to a specific research gap .

It’s important to consider a variety of factors when choosing a topic for your dissertation or thesis . Think about the relevance of the topic, its feasibility , and the resources available to you, including time, data, and academic guidance. Also, consider your own interest and expertise in the subject, as this will sustain you through the research process.

Always consult with your academic advisor to ensure that your chosen topic aligns with academic requirements and offers a meaningful contribution to the field. If you need help choosing a topic, consider our private coaching service.

Good morning everyone. This are very patent topics for research in neuroscience. Thank you for guidance

What if everything is important, original and intresting? as in Neuroscience. I find myself overwhelmd with tens of relveant areas and within each area many optional topics. I ask myself if importance (for example – able to treat people suffering) is more relevant than what intrest me, and on the other hand if what advance me further in my career should not also be a consideration?

This information is really helpful and have learnt alot

Phd research topics on implementation of mental health policy in Nigeria :the prospects, challenges and way forward.

This info is indeed help for someone to formulate a dissertation topic. I have already got my path from here.

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An Exploratory Study of Students with Depression in Undergraduate Research Experiences

Katelyn M. Cooper
Logan E. Gin
M. Elizabeth Barnes
Sara E. Brownell

*Address correspondence to: Katelyn M. Cooper ( E-mail Address: [email protected] ).

Department of Biology, University of Central Florida, Orlando, FL, 32816

Search for more papers by this author

Biology Education Research Lab, Research for Inclusive STEM Education Center, School of Life Sciences, Arizona State University, Tempe, AZ 85281

Depression is a top mental health concern among undergraduates and has been shown to disproportionately affect individuals who are underserved and underrepresented in science. As we aim to create a more inclusive scientific community, we argue that we need to examine the relationship between depression and scientific research. While studies have identified aspects of research that affect graduate student depression, we know of no studies that have explored the relationship between depression and undergraduate research. In this study, we sought to understand how undergraduates’ symptoms of depression affect their research experiences and how research affects undergraduates’ feelings of depression. We interviewed 35 undergraduate researchers majoring in the life sciences from 12 research-intensive public universities across the United States who identify with having depression. Using inductive and deductive coding, we identified that students’ depression affected their motivation and productivity, creativity and risk-taking, engagement and concentration, and self-perception and socializing in undergraduate research experiences. We found that students’ social connections, experiencing failure in research, getting help, receiving feedback, and the demands of research affected students’ depression. Based on this work, we articulate an initial set of evidence-based recommendations for research mentors to consider in promoting an inclusive research experience for students with depression.

INTRODUCTION

Depression is described as a common and serious mood disorder that results in persistent feelings of sadness and hopelessness, as well as a loss of interest in activities that one once enjoyed ( American Psychiatric Association [APA], 2013 ). Additional symptoms of depression include weight changes, difficulty sleeping, loss of energy, difficulty thinking or concentrating, feelings of worthlessness or excessive guilt, and suicidality ( APA, 2013 ). While depression results from a complex interaction of psychological, social, and biological factors ( World Health Organization, 2018 ), studies have shown that increased stress caused by college can be a significant contributor to student depression ( Dyson and Renk, 2006 ).

Depression is one of the top undergraduate mental health concerns, and the rate of depression among undergraduates continues to rise ( Center for Collegiate Mental Health, 2017 ). While we cannot discern whether these increasing rates of depression are due to increased awareness or increased incidence, it is clear that is a serious problem on college campuses. The percent of U.S. college students who self-reported a diagnosis with depression was recently estimated to be about 25% ( American College Health Association, 2019 ). However, higher rates have been reported, with one study estimating that up to 84% of undergraduates experience some level of depression ( Garlow et al. , 2008 ). Depression rates are typically higher among university students compared with the general population, despite being a more socially privileged group ( Ibrahim et al. , 2013 ). Prior studies have found that depression is negatively correlated with overall undergraduate academic performance ( Hysenbegasi et al. , 2005 ; Deroma et al. , 2009 ; American College Health Association, 2019 ). Specifically, diagnosed depression is associated with half a letter grade decrease in students’ grade point average ( Hysenbegasi et al. , 2005 ), and 21.6% of undergraduates reported that depression negatively affected their academic performance within the last year ( American College Health Association, 2019 ). Provided with a list of academic factors that may be affected by depression, students reported that depression contributed to lower exam grades, lower course grades, and not completing or dropping a course.

Students in the natural sciences may be particularly at risk for depression, given that such majors are noted to be particularly stressful due to their competitive nature and course work that is often perceived to “weed students out”( Everson et al. , 1993 ; Strenta et al. , 1994 ; American College Health Association, 2019 ; Seymour and Hunter, 2019 ). Science course instruction has also been described to be boring, repetitive, difficult, and math-intensive; these factors can create an environment that can trigger depression ( Seymour and Hewitt, 1997 ; Osborne and Collins, 2001 ; Armbruster et al ., 2009 ; Ceci and Williams, 2010 ). What also distinguishes science degree programs from other degree programs is that, increasingly, undergraduate research experiences are being proposed as an essential element of a science degree ( American Association for the Advancement of Science, 2011 ; President’s Council of Advisors on Science and Technology, 2012 ; National Academies of Sciences, Engineering, and Medicine [NASEM], 2017 ). However, there is some evidence that undergraduate research experiences can add to the stress of college for some students ( Cooper et al. , 2019c ). Students can garner multiple benefits from undergraduate research, including enhanced abilities to think critically ( Ishiyama, 2002 ; Bauer and Bennett, 2003 ; Brownell et al. , 2015 ), improved student learning ( Rauckhorst et al. , 2001 ; Brownell et al. , 2015 ), and increased student persistence in undergraduate science degree programs ( Jones et al. , 2010 ; Hernandez et al. , 2018 ). Notably, undergraduate research experiences are increasingly becoming a prerequisite for entry into medical and graduate programs in science, particularly elite programs ( Cooper et al. , 2019d ). Although some research experiences are embedded into formal lab courses as course-based undergraduate research experiences (CUREs; Auchincloss et al. , 2014 ; Brownell and Kloser, 2015 ), the majority likely entail working with faculty in their research labs. These undergraduate research experiences in faculty labs are often added on top of a student’s normal course work, so they essentially become an extracurricular activity that they have to juggle with course work, working, and/or personal obligations ( Cooper et al. , 2019c ). While the majority of the literature surrounding undergraduate research highlights undergraduate research as a positive experience ( NASEM, 2017 ), studies have demonstrated that undergraduate research experiences can be academically and emotionally challenging for students ( Mabrouk and Peters, 2000 ; Seymour et al. , 2004 ; Cooper et al. , 2019c ; Limeri et al. , 2019 ). In fact, 50% of students sampled nationally from public R1 institutions consider leaving their undergraduate research experience prematurely, and about half of those students, or 25% of all students, ultimately leave their undergraduate research experience ( Cooper et al. , 2019c ). Notably, 33.8% of these individuals cited a negative lab environment and 33.3% cited negative relationships with their mentors as factors that influenced their decision about whether to leave ( Cooper et al. , 2019c ). Therefore, students’ depression may be exacerbated in challenging undergraduate research experiences, because studies have shown that depression is positively correlated with student stress ( Hish et al. , 2019 ).

While depression has not been explored in the context of undergraduate research experiences, depression has become a prominent concern surrounding graduate students conducting scientific research. A recent study that examined the “graduate student mental health crisis” ( Flaherty, 2018 ) found that work–life balance and graduate students’ relationships with their research advisors may be contributing to their depression ( Evans et al. , 2018 ). Specifically, this survey of 2279 PhD and master’s students from diverse fields of study, including the biological/physical sciences, showed that 39% of graduate students have experienced moderate to severe depression. Fifty-five percent of the graduate students with depression who were surveyed disagreed with the statement “I have good work life balance,” compared to only 21% of students with depression who agreed. Additionally, the study highlighted that more students with depression disagreed than agreed with the following statements: their advisors provided “real” mentorship, their advisors provided ample support, their advisors positively impacted their emotional or mental well-being, their advisors were assets to their careers, and they felt valued by their mentors. Another recent study identified that depression severity in biomedical doctoral students was significantly associated with graduate program climate, a perceived lack of employment opportunities, and the quality of students’ research training environment ( Nagy et al. , 2019 ). Environmental stress, academic stress, and family and monetary stress have also been shown to be predictive of depression severity in biomedical doctoral students ( Hish et al. , 2019 ). Further, one study found that self-esteem is negatively correlated and stress is positively correlated with graduate student depression; presumably research environments that challenge students’ self-esteem and induce stress are likely contributing to depressive symptoms among graduate students ( Kreger, 1995 ). While these studies have focused on graduate students, and there are certainly notable distinctions between graduate and undergraduate research, the research-related factors that affect graduate student depression, including work–life balance, relationships with mentors, research environment, stress, and self-esteem, may also be relevant to depression among undergraduates conducting research. Importantly, undergraduates in the United States have reported identical levels of depression as graduate students but are often less likely to seek mental health care services ( Wyatt and Oswalt, 2013 ), which is concerning if undergraduate research experiences exacerbate depression.

Based on the literature on the stressors of undergraduate research experiences and the literature identifying some potential causes of graduate student depression, we identified three aspects of undergraduate research that may exacerbate undergraduates’ depression. Mentoring: Mentors can be an integral part of a students’ research experience, bolstering their connections with others in the science community, scholarly productivity, and science identity, as well as providing many other benefits ( Thiry and Laursen, 2011 ; Prunuske et al. , 2013 ; Byars-Winston et al. , 2015 ; Aikens et al. , 2016 , 2017 ; Thompson et al. , 2016 ; Estrada et al. , 2018 ). However, recent literature has highlighted that poor mentoring can negatively affect undergraduate researchers ( Cooper et al. , 2019c ; Limeri et al. , 2019 ). Specifically, one study of 33 undergraduate researchers who had conducted research at 10 institutions identified seven major ways that they experienced negative mentoring, which included absenteeism, abuse of power, interpersonal mismatch, lack of career support, lack of psychosocial support, misaligned expectations, and unequal treatment ( Limeri et al. , 2019 ). We hypothesize negative mentoring experiences may be particularly harmful for students with depression, because support, particularly social support, has been shown to be important for helping individuals with depression cope with difficult circumstances ( Aneshensel and Stone, 1982 ; Grav et al. , 2012 ). Failure: Experiencing failure has been hypothesized to be an important aspect of undergraduate research experiences that may help students develop some the most distinguishing abilities of outstanding scientists, such as coping with failure, navigating challenges, and persevering ( Laursen et al. , 2010 ; Gin et al. , 2018 ; Henry et al. , 2019 ). However, experiencing failure and the stress and fatigue that often accompany it may be particularly tough for students with depression ( Aldwin and Greenberger, 1987 ; Mongrain and Blackburn, 2005 ). Lab environment: Fairness, inclusion/exclusion, and social support within one’s organizational environment have been shown to be key factors that cause people to either want to remain in the work place and be productive or to want to leave ( Barak et al. , 2006 ; Cooper et al. , 2019c ). We hypothesize that dealing with exclusion or a lack of social support may exacerbate depression for some students; patients with clinical depression react to social exclusion with more pronounced negative emotions than do individuals without clinical depression ( Jobst et al. , 2015 ). While there are likely other aspects of undergraduate research that affect student depression, we hypothesize that these factors have the potential to exacerbate negative research experiences for students with depression.

Depression has been shown to disproportionately affect many populations that are underrepresented or underserved within the scientific community, including females ( American College Health Association, 2018 ; Evans et al. , 2018 ), first-generation college students ( Jenkins et al. , 2013 ), individuals from low socioeconomic backgrounds ( Eisenberg et al. , 2007 ), members of the LGBTQ+ community ( Eisenberg et al. , 2007 ; Evans et al. , 2018 ), and people with disabilities ( Turner and Noh, 1988 ). Therefore, as the science community strives to be more diverse and inclusive ( Intemann, 2009 ), it is important that we understand more about the relationship between depression and scientific research, because negative experiences with depression in scientific research may be contributing to the underrepresentation of these groups. Specifically, more information is needed about how the research process and environment of research experiences may affect depression.

Given the high rate of depression among undergraduates, the links between depression and graduate research, the potentially challenging environment of undergraduate research, and how depression could disproportionately impact students from underserved communities, it is imperative to begin to explore the relationship between scientific research and depression among undergraduates to create research experiences that could maximize student success. In this exploratory interview study, we aimed to 1) describe how undergraduates’ symptoms of depression affect their research experiences, 2) understand how undergraduate research affects students’ feelings of depression, and 3) identify recommendations based on the literature and undergraduates’ reported experiences to promote a positive research experience for students with depression.

This study was done with an approved Arizona State University Institutional Review Board protocol #7247.

In Fall 2018, we surveyed undergraduate researchers majoring in the life sciences across 25 research-intensive (R1) public institutions across the United States (specific details about the recruitment of the students who completed the survey can be found in Cooper et al. (2019c) ). The survey asked students for their opinions about their undergraduate research experiences and their demographic information and whether they would be interested in participating in a follow-up interview related to their research experiences. For the purpose of this study, we exclusively interviewed students about their undergraduate research experiences in faculty member labs; we did not consider students’ experiences in CUREs. Of the 768 undergraduate researchers who completed the survey, 65% ( n = 496) indicated that they would be interested in participating in a follow-up interview. In Spring 2019, we emailed the 496 students, explaining that we were interested in interviewing students with depression about their experiences in undergraduate research. Our specific prompt was: “If you identify as having depression, we would be interested in hearing about your experience in undergraduate research in a 30–60 minute online interview.” We did not define depression in our email recruitment because we conducted think-aloud interviews with four undergraduates who all correctly interpreted what we meant by depression ( APA, 2013 ). We had 35 students agree to participate in the interview study. The interview participants represented 12 of the 25 R1 public institutions that were represented in the initial survey.

Student Interviews

We developed an interview script to explore our research questions. Specifically, we were interested in how students’ symptoms of depression affect their research experiences, how undergraduate research negatively affects student depression, and how undergraduate research positively affects student depression.

We recognized that mental health, and specifically depression, can be a sensitive topic to discuss with undergraduates, and therefore we tried to minimize any discomfort that the interviewees might experience during the interview. Specifically, we conducted think-aloud interviews with three graduate students who self-identified with having depression at the time of the interview. We asked them to note whether any interview questions made them uncomfortable. We also sought their feedback on questions given their experiences as persons with depression who had once engaged in undergraduate research. We revised the interview protocol after each think-aloud interview. Next, we conducted four additional think-aloud interviews with undergraduates conducting basic science or biology education research who identified with having depression to establish cognitive validity of the questions and to elicit additional feedback about any questions that might make someone uncomfortable. The questions were revised after each think-aloud interview until no question was unclear or misinterpreted by the students and we were confident that the questions minimized students’ potential discomfort ( Trenor et al. , 2011 ). A copy of the final interview script can be found in the Supplemental Material.

All interviews were individually conducted by one of two researchers (K.M.C. and L.E.G.) who conducted the think-aloud interviews together to ensure that their interviewing practices were as similar as possible. The interviews were approximately an hour long, and students received a $15 gift card for their participation.

Personal, Research, and Depression Demographics

All student demographics and information about students’ research experiences were collected using the survey distributed to students in Fall 2018. We collected personal demographics, including the participants’ gender, race/ethnicity, college generation status, transfer status, financial stability, year in college, major, and age. We also collected information about the students’ research experiences, including the length of their first research experiences, the average number of hours they spend in research per week, how they were compensated for research, who their primary mentors were, and the focus areas of their research.

In the United States, mental healthcare is disproportionately unavailable to Black and Latinx individuals, as well as those who come from low socioeconomic backgrounds ( Kataoka et al. , 2002 ; Howell and McFeeters, 2008 ; Santiago et al. , 2013 ). Therefore, to minimize a biased sample, we invited anyone who identified with having depression to participate in our study; we did not require students to be diagnosed with depression or to be treated for depression in order to participate. However, we did collect information about whether students had been formally diagnosed with depression and whether they had been treated for depression. After the interview, all participants were sent a link to a short survey that asked them if they had ever been diagnosed with depression and how, if at all, they had ever been treated for depression. A copy of these survey questions can be found in the Supplemental Material. The combined demographic information of the participants is in Table 1 . The demographics for each individual student can be found in the Supplemental Material.

Student-level demographics, research demographics, and depression demographics of the 35 interview participants
Student-level demographics	Interview participants = 35 (%)	Research demographics	Interview participants = 35 (%)	Depression demographics	Interview participants = 35 (%)

Female	27 (77%)	Less than 6 months	7 (20%)	Yes	21 (60%)
Male	7 (23%)	6 months	6 (17%)	No	10 (29%)
Declined to state	1 (3%)	1 year	11 (31%)	Declined to state	4 (11%)
		1.5 years	4 (11%)
Asian	9 (26%)	2 years	2 (6%)	Medication	15 (43%)
Black	1 (3%)	3 years	3 (9%)	Counseling	17 (49%)
Latinx	5 (14%)	3.5 years	1 (3%)	Other	2 (6%)
Middle Eastern	1 (3%)	Declined to state	1 (3%)	No treatment	15 (43%)
Mixed race	1 (3%)			Declined to state	2 (6%)
White	17 (49%)	1–5 hours	6 (17%)
Declined to state	1 (3%)	6–10 hours	16 (46%)
		11–15 hours	7 (20%)
First generation	10 (29%)	16 + hours	5 (14%)
Continuing generation	24 (69%)	Declined to state	1 (3%)
Declined to state	1 (3%)
		Money	13 (37%)
Transfer	5 (14%)	Course credit	24 (69%)
Nontransfer	29 (83%)	Volunteer	7 (20%)
Declined to state	1 (3%)	Declined to state	2 (6%)

No	6 (17%)	PI	9 (26%)
Yes, but only sometimes	12 (34%)	Postdoc	3 (9%)
Yes	16 (46%)	Graduate student	14 (40%)
Declined to state	1 (3%)	Staff member	7 (20%)
		Undergraduate student	1 (3%)
First year	1 (3%)	Declined to state	1 (3%)
Second year	5 (14%)
Third year	6 (17%)	Cell/molecular biology	4 (11%)
Fourth year or greater	22 (63%)	Ecology/evolution	9 (26%)
Declined to state	1 (3%)	Genetics	5 (14%)
		Immunology	4 (11%)
Biology	32 (91%)	Neuroscience	3 (9%)
Biochemistry	2 (6%)	Physiology/health	3 (9%)
Declined to state	1 (3%)	Other	6 (17%)
		Declined to state	1 (3%)
18–19	5 (14%)
20–21	17 (49%)
22–23	11 (31%)
24 or older	1 (3%)
Declined to state	1 (3%)

a Students reported the time they had spent in research 6 months before being interviewed and only reported on the length of time of their first research experiences.

b Students were invited to report multiple ways in which they were treated for their depression; other treatments included lifestyle changes and meditation.

c Students were invited to report multiple means of compensation for their research if they had been compensated for their time in different ways.

d Students were asked whether they felt financially stable, particularly during the undergraduate research experience.

e Students reported who they work/worked with most closely during their research experiences.

f Staff members included lab coordinators or lab managers.

g Other focus areas of research included sociology, linguistics, psychology, and public health.

Interview Analysis

The initial interview analysis aimed to explore each idea that a participant expressed ( Charmaz, 2006 ) and to identify reoccurring ideas throughout the interviews. First, three authors (K.M.C., L.E.G., and S.E.B.) individually reviewed a different set of 10 interviews and took detailed analytic notes ( Birks and Mills, 2015 ). Afterward, the authors compared their notes and identified reoccurring themes throughout the interviews using open coding methods ( Saldaña, 2015 ).

Once an initial set of themes was established, two researchers (K.M.C. and L.E.G.) individually reviewed the same set of 15 randomly selected interviews to validate the themes identified in the initial analysis and to screen for any additional themes that the initial analysis may have missed. Each researcher took detailed analytic notes throughout the review of an interview, which they discussed after reviewing each interview. The researchers compared what quotes from each interview they categorized into each theme. Using constant comparison methods, they assigned quotes to each theme and constantly compared the quotes to ensure that each quote fit within the description of the theme ( Glesne and Peshkin, 1992 ). In cases in which quotes were too different from other quotes, a new theme was created. This approach allowed for multiple revisions of the themes and allowed the authors to define a final set of codes; the researchers created a final codebook with refined definitions of emergent themes (the final coding rubric can be found in the Supplemental Material). Once the final codebook was established, the researchers (K.M.C. and L.E.G.) individually coded seven additional interviews (20% of all interviews) using the coding rubric. The researchers compared their codes, and their Cohen’s κ interrater score for these seven interviews was at an acceptable level (κ = 0.88; Landis and Koch, 1977 ). One researcher (L.E.G.) coded the remaining 28 out of 35 interviews. The researchers determined that data saturation had been reached with the current sample and no further recruitment was needed ( Guest et al. , 2006 ). We report on themes that were mentioned by at least 20% of students in the interview study. In the Supplemental Material, we provide the final coding rubric with the number of participants whose interview reflected each theme ( Hannah and Lautsch, 2011 ). Reporting the number of individuals who reported themes within qualitative data can lead to inaccurate conclusions about the generalizability of the results to a broader population. These qualitative data are meant to characterize a landscape of experiences that students with depression have in undergraduate research rather than to make claims about the prevalence of these experiences ( Glesne and Peshkin, 1992 ). Because inferences about the importance of these themes cannot be drawn from these counts, they are not included in the results of the paper ( Maxwell, 2010 ). Further, the limited number of interviewees made it not possible to examine whether there were trends based on students’ demographics or characteristics of their research experiences (e.g., their specific area of study). Quotes were lightly edited for clarity by inserting clarification brackets and using ellipses to indicate excluded text. Pseudonyms were given to all students to protect their privacy.

The Effect of Depressive Symptoms on Undergraduate Research

We asked students to describe the symptoms associated with their depression. Students described experiencing anxiety that is associated with their depression; this could be anxiety that precedes their depression or anxiety that results from a depressive episode or a period of time when an individual has depression symptoms. Further, students described difficulty getting out of bed or leaving the house, feeling tired, a lack of motivation, being overly self-critical, feeling apathetic, and having difficulty concentrating. We were particularly interested in how students’ symptoms of depression affected their experiences in undergraduate research. During the think-aloud interviews that were conducted before the interview study, graduate and undergraduate students consistently described that their depression affected their motivation in research, their creativity in research, and their productivity in research. Therefore, we explicitly asked undergraduate researchers how, if at all, their depression affected these three factors. We also asked students to describe any additional ways in which their depression affected their research experiences. Undergraduate researchers commonly described five additional ways in which their depression affected their research; for a detailed description of each way students’ research was affected and for example quotes, see Table 2 . Students described that their depression negatively affected their productivity in the lab. Commonly, students described that their productivity was directly affected by a lack of motivation or because they felt less creative, which hindered the research process. Additionally, students highlighted that they were sometimes less productive because their depression sometimes caused them to struggle to engage intellectually with their research or caused them to have difficulty remembering or concentrating; students described that they could do mundane or routine tasks when they felt depressed, but that they had difficulty with more complex and intellectually demanding tasks. However, students sometimes described that even mundane tasks could be difficult when they were required to remember specific steps; for example, some students struggled recalling a protocol from memory when their depression was particularly severe. Additionally, students noted that their depression made them more self-conscious, which sometimes held them back from sharing research ideas with their mentors or from taking risks such as applying to competitive programs. In addition to being self-conscious, students highlighted that their depression caused them to be overly self-critical, and some described experiencing imposter phenomenon ( Clance and Imes, 1978 ) or feeling like they were not talented enough to be in research and were accepted into a lab by a fluke or through luck. Finally, students described that depression often made them feel less social, and they struggled to socially engage with other members of the lab when they were feeling down.

Ways in which students report that depression affected their undergraduate research experience with example student quotes
	Description	Example quote 1	Example quote 2
Motivation and productivity
Lack of motivation in research	Students describe that their depression can cause them to feel unmotivated to do research.	Crystal: “[Depression] can make it hard to motivate myself to keep doing [research] because when I get into [depression] it doesn’t matter. [All my organisms] are going to die and everything’s going to go horribly sideways and why do I even bother? And then that can descend into a state of just sadness or apathy or a combination of the two.”	Naomi: “I don’t feel as motivated to do the research because I just don’t feel like doing anything. [Depression] definitely does not help with the motivation.”
Less productive	Students describe that depression can cause them to be less productive, less efficient, or to move slower than usual.	Marta: “I think at times when [my depression is] really, really bad, I’ll just find myself just sitting at my desk looking busy but not actually doing anything. (…) And I think that obviously affects productivity because I’m not really doing anything.”	Julie: “I think I literally moved and thought slower. (…) I think that if I could redo all of that time while not depressed, I would have gotten so much more done. I feel like so much of this stalling I had on various projects was because of [my depression].”
Creativity and risk-taking
Lack of creativity in research	Students describe that depression can cause them to be less creative in their research.	Michelle: “In that depressive episode, I probably won’t be even using my brain in that, sort of, [creative] sense. My mind will probably be just so limited and blank and I won’t even want to think creatively.”	Amy: “I think [depression] definitely has super negatively impacted my research creativity. I just feel like I’m not as creative with my problem solving skills when I am depressed as when I am not depressed.”
Held back from taking risks or contributing thoughts and ideas	Students describe that their depression can hold them back from sharing an idea with their lab mates or from taking risks like applying for competitive positions or trying something in research that might not work.	Marta: “[Depression affects my research] because I’m so scared to take a risk. That has really put a very short cap on what I’ve been able to do. And maybe I would’ve been able to get internships at institutions like my peers. But instead, because I was so limited by my depression, it kept me from doing that.”	Christian: “That’s where I think [depression] definitely negatively affects what I have accomplished just because I feel personally that I could have achieved more if I wasn’t held down, I guess, by depression. So, I feel like I would’ve been able to put myself out there more and take more risks, reaching out to others to take opportunities when I was in lab.”
Engagement and concentration
Struggle to intellectually engage	Students describe that they struggle to do research activities that require intellectual engagement when they are feeling depressed.	Freddy: “I find mechanical things like actually running an experiment in the lab, I can pretty much do regardless of how I’m feeling. But things that require a ton of mental energy, like analyzing data, doing statistics, or actually writing, was [ ] a lot more difficult if I was feeling depressed.”	Rose: “When you’re working on a research project you’re like ‘I wonder what this does? Or why is that the way it is?,’ and then you’ll read more articles and talk to a few people. And when I’m depressed, I don’t care. I’m like this is just another thing I have to do.”
Difficulty concentrating or remembering	Students describe that, because of their depression, they can have difficulty concentrating or remembering when they are conducting research.	Julie: “My memory absolutely goes to hell, especially my short-term memory. My attention span nosedives. Later, I will look back on work and have no idea how any of that made sense to me.”	Adrianna: “Yeah. [Sometimes when I’m depressed] it’s like, ‘Oh, I forgot a step,’ or ‘Oh, I mislabeled the tube.’ It’s like, okay, I got to slow down even more and pay more attention. But it’s really hard to get myself to focus.”
Self-perception and socializing
Overly self-critical	Students describe that depression causes them to have low self-esteem or to be overly self-critical.	Heather: “I guess [my depression can cause me to] beat myself up about different things. Especially when the experiment didn’t really work. I guess blaming myself to the point where it was unhealthy about different things. If I had an experiment and it didn’t work, even if I was working with someone else, then I’d put all the blame on myself. I guess [your depression] worsens it because you just feel worse about yourself mentally.”	Taylor: “I feel like I’m sort of not good enough, right? And I’ve sort of fooled [my research advisor] for letting me into their lab, and that I should just stop. I guess that’s really how [my depression] would relate directly to research.”
Less social	Students describe that their depression can cause them to not want to interact with others in the lab or to be less social in general.	Adrianna: “There are days I’m emotionally flat and obviously those I just don’t engage in conversation as much and [my lab mates] are probably like, ‘Oh, she’s just under the weather.’ I don’t know. It just affects my ability to want to sit down and talk to somebody.”	Michelle: “When I’m depressed I won’t talk as much, so [my lab mates and I] won’t have a conversation.”

The Effect of Undergraduate Research Experiences on Student Depression

We also wanted to explore how research impacted students’ feelings of depression. Undergraduates described how research both positively and negatively affected their depression. In the following sections, we present aspects of undergraduate research and examine how each positively and/or negatively affected students’ depression using embedded student quotes to highlight the relationships between related ideas.

Lab Environment: Relationships with Others in the Lab.

Some aspects of the lab environment, which we define as students’ physical, social, or psychological research space, could be particularly beneficial for students with depression.

Specifically, undergraduate researchers perceived that comfortable and positive social interactions with others in the lab helped their depression. Students acknowledged how beneficial their relationships with graduate students and postdocs could be.

Marta: “I think always checking in on undergrads is important. It’s really easy [for us] to go a whole day without talking to anybody in the lab. But our grad students are like ‘Hey, what’s up? How’s school? What’s going on?’ (…) What helps me the most is having that strong support system. Sometimes just talking makes you feel better, but also having people that believe in you can really help you get out of that negative spiral. I think that can really help with depression.”

Kelley: “I know that anytime I need to talk to [my postdoc mentors] about something they’re always there for me. Over time we’ve developed a relationship where I know that outside of work and outside of the lab if I did want to talk to them about something I could talk to them. Even just talking to someone about hobbies and having that relationship alone is really helpful [for depression].”

In addition to highlighting the importance of developing relationships with graduate students or postdocs in the lab, students described that forming relationships with other undergraduates in the lab also helped their depression. Particularly, students described that other undergraduate researchers often validated their feelings about research, which in turn helped them realize that what they are thinking or feeling is normal, which tended to alleviate their negative thoughts. Interestingly, other undergraduates experiencing the same issues could sometimes help buffer them from perceiving that a mentor did not like them or that they were uniquely bad at research. In this article, we use the term “mentor” to refer to anyone who students referred to in the interviews as being their mentors or managing their research experiences; this includes graduate students, postdoctoral scholars, lab managers, and primary investigators (PIs).

Abby: “One of my best friends is in the lab with me. A lot of that friendship just comes from complaining about our stress with the lab and our annoyance with people in the lab. Like when we both agree like, ‘Yeah, the grad students were really off today, it wasn’t us,’ that helps. ‘It wasn’t me, it wasn’t my fault that we were having a rough day in lab; it was the grad students.’ Just being able to realize, ‘Hey, this isn’t all caused by us,’ you know? (…) We understand the stresses in the lab. We understand the details of what each other are doing in the lab, so when something doesn’t work out, we understand that it took them like eight hours to do that and it didn’t work. We provide empathy on a different level.”

Meleana: “It’s great to have solidarity in being confused about something, and it’s just that is a form of validation for me too. When we leave a lab meeting and I look at [another undergrad] I’m like, ‘Did you understand anything that they were just saying?’ And they’re like, ‘Oh, no.’ (…) It’s just really validating to hear from the other undergrads that we all seem to be struggling with the same things.”

Developing positive relationships with faculty mentors or PIs also helped alleviate some students’ depressive feelings, particularly when PIs shared their own struggles with students. This also seemed to normalize students’ concerns about their own experiences.

Alexandra: “[Talking with my PI] is helpful because he would talk about his struggles, and what he faced. A lot of it was very similar to my struggles. For example, he would say, ‘Oh, yeah, I failed this exam that I studied so hard for. I failed the GRE and I paid so much money to prepare for it.’ It just makes [my depression] better, like okay, this is normal for students to go through this. It’s not an out of this world thing where if you fail, you’re a failure and you can’t move on from it.”

Students’ relationships with others in the lab did not always positively impact their depression. Students described instances when the negative moods of the graduate students and PIs would often set the tone of the lab, which in turn worsened the mood of the undergraduate researchers.

Abby: “Sometimes [the grad students] are not in a good mood. The entire vibe of the lab is just off, and if you make a joke and it hits somebody wrong, they get all mad. It really depends on the grad students and the leadership and the mood that they’re in.”

Interviewer: “How does it affect your depression when the grad students are in a bad mood?”

Abby: “It definitely makes me feel worse. It feels like, again, that I really shouldn’t go ask them for help because they’re just not in the mood to help out. It makes me have more pressure on myself, and I have deadlines I need to meet, but I have a question for them, but they’re in a bad mood so I can’t ask. That’s another day wasted for me and it just puts more stress, which just adds to the depression.”

Additionally, some students described even more concerning behavior from research mentors, which negatively affected their depression.

Julie: “I had a primary investigator who is notorious in the department for screaming at people, being emotionally abusive, unreasonable, et cetera. (…) [He was] kind of harassing people, demeaning them, lying to them, et cetera, et cetera. (…) Being yelled at and constantly demeaned and harassed at all hours of the day and night, that was probably pretty bad for me.”

While the relationships between undergraduates and graduate, postdoc, and faculty mentors seemed to either alleviate or worsen students’ depressive symptoms, depending on the quality of the relationship, students in this study exclusively described their relationships with other undergraduates as positive for their depression. However, students did note that undergraduate research puts some of the best and brightest undergraduates in the same environment, which can result in students comparing themselves with their peers. Students described that this comparison would often lead them to feel badly about themselves, even though they would describe their personal relationship with a person to be good.

Meleana: “In just the research field in general, just feeling like I don’t really measure up to the people around me [can affect my depression]. A lot of the times it’s the beginning of a little spiral, mental spiral. There are some past undergrads that are talked about as they’re on this pedestal of being the ideal undergrads and that they were just so smart and contributed so much to the lab. I can never stop myself from wondering like, ‘Oh, I wonder if I’m having a contribution to the lab that’s similar or if I’m just another one of the undergrads that does the bare minimum and passes through and is just there.’”

Natasha: “But, on the other hand, [having another undergrad in the lab] also reminded me constantly that some people are invested in this and meant to do this and it’s not me. And that some people know a lot more than I do and will go further in this than I will.”

While students primarily expressed that their relationships with others in the lab affected their depression, some students explained that they struggled most with depression when the lab was empty; they described that they did not like being alone in the lab, because a lack of stimulation allowed their minds to be filled with negative thoughts.

Mia: “Those late nights definitely didn’t help [my depression]. I am alone, in the entire building. I’m left alone to think about my thoughts more, so not distracted by talking to people or interacting with people. I think more about how I’m feeling and the lack of progress I’m making, and the hopelessness I’m feeling. That kind of dragged things on, and I guess deepened my depression.”

Freddy: “Often times when I go to my office in the evening, that is when I would [ sic ] be prone to be more depressed. It’s being alone. I think about myself or mistakes or trying to correct mistakes or whatever’s going on in my life at the time. I become very introspective. I think I’m way too self-evaluating, way too self-deprecating and it’s when I’m alone when those things are really, really triggered. When I’m talking with somebody else, I forget about those things.”

In sum, students with depression highlighted that a lab environment full of positive and encouraging individuals was helpful for their depression, whereas isolating or competitive environments and negative interactions with others often resulted in more depressive feelings.

Doing Science: Experiencing Failure in Research, Getting Help, Receiving Feedback, Time Demands, and Important Contributions.

In addition to the lab environment, students also described that the process of doing science could affect their depression. Specifically, students explained that a large contributor to their depression was experiencing failure in research.

Interviewer: “Considering your experience in undergraduate research, what tends to trigger your feelings of depression?”

Heather: “Probably just not getting things right. Having to do an experiment over and over again. You don’t get the results you want. (…) The work is pretty meticulous and it’s frustrating when I do all this work, I do a whole experiment, and then I don’t get any results that I can use. That can be really frustrating. It adds to the stress. (…) It’s hard because you did all this other stuff before so you can plan for the research, and then something happens and all the stuff you did was worthless basically.”

Julie: “I felt very negatively about myself [when a project failed] and pretty panicked whenever something didn’t work because I felt like it was a direct reflection on my effort and/or intelligence, and then it was a big glaring personal failure.”

Students explained that their depression related to failing in research was exacerbated if they felt as though they could not seek help from their research mentors. Perceived insufficient mentor guidance has been shown to be a factor influencing student intention to leave undergraduate research ( Cooper et al. , 2019c ). Sometimes students talked about their research mentors being unavailable or unapproachable.

Michelle: “It just feels like [the graduate students] are not approachable. I feel like I can’t approach them to ask for their understanding in a certain situation. It makes [my depression] worse because I feel like I’m stuck, and that I’m being limited, and like there’s nothing I can do. So then I kind of feel like it’s my fault that I can’t do anything.”

Other times, students described that they did not seek help in fear that they would be negatively evaluated in research, which is a fear of being judged by others ( Watson and Friend, 1969 ; Weeks et al. , 2005 ; Cooper et al. , 2018 ). That is, students fear that their mentor would think negatively about them or judge them if they were to ask questions that their mentor thought they should know the answer to.

Meleana: “I would say [my depression] tends to come out more in being more reserved in asking questions because I think that comes more like a fear-based thing where I’m like, ‘Oh, I don’t feel like I’m good enough and so I don’t want to ask these questions because then my mentors will, I don’t know, think that I’m dumb or something.’”

Conversely, students described that mentors who were willing to help them alleviated their depressive feelings.

Crystal: “Yeah [my grad student] is always like, ‘Hey, I can check in on things in the lab because you’re allowed to ask me for that, you’re not totally alone in this,’ because he knows that I tend to take on all this responsibility and I don’t always know how to ask for help. He’s like, ‘You know, this is my lab too and I am here to help you as well,’ and just reminds me that I’m not shouldering this burden by myself.”

Ashlyn: “The graduate student who I work with is very kind and has a lot of patience and he really understands a lot of things and provides simple explanations. He does remind me about things and he will keep on me about certain tasks that I need to do in an understanding way, and it’s just because he’s patient and he listens.”

In addition to experiencing failure in science, students described that making mistakes when doing science also negatively affected their depression.

Abby: “I guess not making mistakes on experiments [is important in avoiding my depression]. Not necessarily that your experiment didn’t turn out to produce the data that you wanted, but just adding the wrong enzyme or messing something up like that. It’s like, ‘Oh, man,’ you know? You can get really down on yourself about that because it can be embarrassing.”

Commonly, students described that the potential for making mistakes increased their stress and anxiety regarding research; however, they explained that how other people responded to a potential mistake was what ultimately affected their depression.

Briana: “Sometimes if I made a mistake in correctly identifying an eye color [of a fly], [my PI] would just ridicule me in front of the other students. He corrected me but his method of correcting was very discouraging because it was a ridicule. It made the others laugh and I didn’t like that.”

Julie: “[My PI] explicitly [asked] if I had the dedication for science. A lot of times he said I had terrible judgment. A lot of times he said I couldn’t be trusted. Once I went to a conference with him, and, unfortunately, in front of another professor, he called me a klutz several times and there was another comment about how I never learn from my mistakes.”

When students did do things correctly, they described how important it could be for them to receive praise from their mentors. They explained that hearing praise and validation can be particularly helpful for students with depression, because their thoughts are often very negative and/or because they have low self-esteem.

Crystal: “[Something that helps my depression is] I have text messages from [my graduate student mentor] thanking me [and another undergraduate researcher] for all of the work that we’ve put in, that he would not be able to be as on track to finish as he is if he didn’t have our help.”

Interviewer: “Why is hearing praise from your mentor helpful?”

Crystal: “Because a lot of my depression focuses on everybody secretly hates you, nobody likes you, you’re going to die alone. So having that validation [from my graduate mentor] is important, because it flies in the face of what my depression tells me.”

Brian: “It reminds you that you exist outside of this negative world that you’ve created for yourself, and people don’t see you how you see yourself sometimes.”

Students also highlighted how research could be overwhelming, which negatively affected their depression. Particularly, students described that research demanded a lot of their time and that their mentors did not always seem to be aware that they were juggling school and other commitments in addition to their research. This stress exacerbated their depression.

Rose: “I feel like sometimes [my grad mentors] are not very understanding because grad students don’t take as many classes as [undergrads] do. I think sometimes they don’t understand when I say I can’t come in at all this week because I have finals and they’re like, ‘Why though?’”

Abby: “I just think being more understanding of student life would be great. We have classes as well as the lab, and classes are the priority. They forget what it’s like to be a student. You feel like they don’t understand and they could never understand when you say like, ‘I have three exams this week,’ and they’re like, ‘I don’t care. You need to finish this.’”

Conversely, some students reported that their research labs were very understanding of students’ schedules. Interestingly, these students talked most about how helpful it was to be able to take a mental health day and not do research on days when they felt down or depressed.

Marta: “My lab tech is very open, so she’ll tell us, ‘I can’t come in today. I have to take a mental health day.’ So she’s a really big advocate for that. And I think I won’t personally tell her that I’m taking a mental health day, but I’ll say, ‘I can’t come in today, but I’ll come in Friday and do those extra hours.’ And she’s like, ‘OK great, I’ll see you then.’ And it makes me feel good, because it helps me take care of myself first and then I can take care of everything else I need to do, which is amazing.”

Meleana: “Knowing that [my mentors] would be flexible if I told them that I’m crazy busy and can’t come into work nearly as much this week [helps my depression]. There is flexibility in allowing me to then care for myself.”

Interviewer: “Why is the flexibility helpful given the depression?”

Meleana: “Because sometimes for me things just take a little bit longer when I’m feeling down. I’m just less efficient to be honest, and so it’s helpful if I feel like I can only go into work for 10 hours in a week. It declutters my brain a little bit to not have to worry about all the things I have to do in work in addition the things that I need to do for school or clubs, or family or whatever.”

Despite the demanding nature of research, a subset of students highlighted that their research and research lab provided a sense of stability or familiarity that distracted them from their depression.

Freddy: “I’ll [do research] to run away from those [depressive] feelings or whatever. (…) I find sadly, I hate to admit it, but I do kind of run to [my lab]. I throw myself into work to distract myself from the feelings of depression and sadness.”

Rose: “When you’re sad or when you’re stressed you want to go to things you’re familiar with. So because lab has always been in my life, it’s this thing where it’s going to be there for me I guess. It’s like a good book that you always go back to and it’s familiar and it makes you feel good. So that’s how lab is. It’s not like the greatest thing in the world but it’s something that I’m used to, which is what I feel like a lot of people need when they’re sad and life is not going well.”

Many students also explained that research positively affects their depression because they perceive their research contribution to be important.

Ashlyn: “I feel like I’m dedicating myself to something that’s worthy and something that I believe in. It’s really important because it contextualizes those times when I am feeling depressed. It’s like, no, I do have these better things that I’m working on. Even when I don’t like myself and I don’t like who I am, which is again, depression brain, I can at least say, ‘Well, I have all these other people relying on me in research and in this area and that’s super important.’”

Jessica: “I mean, it just felt like the work that I was doing had meaning and when I feel like what I’m doing is actually going to contribute to the world, that usually really helps with [depression] because it’s like not every day you can feel like you’re doing something impactful.”

In sum, students highlighted that experiencing failure in research and making mistakes negatively contributed to depression, especially when help was unavailable or research mentors had a negative reaction. Additionally, students acknowledged that the research could be time-consuming, but that research mentors who were flexible helped assuage depressive feelings that were associated with feeling overwhelmed. Finally, research helped some students’ depression, because it felt familiar, provided a distraction from depression, and reminded students that they were contributing to a greater cause.

We believe that creating more inclusive research environments for students with depression is an important step toward broadening participation in science, not only to ensure that we are not discouraging students with depression from persisting in science, but also because depression has been shown to disproportionately affect underserved and underrepresented groups in science ( Turner and Noh, 1988 ; Eisenberg et al. , 2007 ; Jenkins et al. , 2013 ; American College Health Association, 2018 ). We initially hypothesized that three features of undergraduate research—research mentors, the lab environment, and failure—may have the potential to exacerbate student depression. We found this to be true; students highlighted that their relationships with their mentors as well as the overall lab environment could negatively affect their depression, but could also positively affect their research experiences. Students also noted that they struggled with failure, which is likely true of most students, but is known to be particularly difficult for students with depression ( Elliott et al. , 1997 ). We expand upon our findings by integrating literature on depression with the information that students provided in the interviews about how research mentors can best support students. We provide a set of evidence-based recommendations focused on mentoring, the lab environment, and failure for research mentors wanting to create more inclusive research environments for students with depression. Notably, only the first recommendation is specific to students with depression; the others reflect recommendations that have previously been described as “best practices” for research mentors ( NASEM, 2017 , 2019 ; Sorkness et al. , 2017 ) and likely would benefit most students. However, we examine how these recommendations may be particularly important for students with depression. As we hypothesized, these recommendations directly address three aspects of research: mentors, lab environment, and failure. A caveat of these recommendations is that more research needs to be done to explore the experiences of students with depression and how these practices actually impact students with depression, but our national sample of undergraduate researchers with depression can provide an initial starting point for a discussion about how to improve research experiences for these students.

Recommendations to Make Undergraduate Research Experiences More Inclusive for Students with Depression

Recognize student depression as a valid illness..

Allow students with depression to take time off of research by simply saying that they are sick and provide appropriate time for students to recover from depressive episodes. Also, make an effort to destigmatize mental health issues.

Undergraduate researchers described both psychological and physical symptoms that manifested as a result of their depression and highlighted how such symptoms prevented them from performing to their full potential in undergraduate research. For example, students described how their depression would cause them to feel unmotivated, which would often negatively affect their research productivity. In cases in which students were motivated enough to come in and do their research, they described having difficulty concentrating or engaging in the work. Further, when doing research, students felt less creative and less willing to take risks, which may alter the quality of their work. Students also sometimes struggled to socialize in the lab. They described feeling less social and feeling overly self-critical. In sum, students described that, when they experienced a depressive episode, they were not able to perform to the best of their ability, and it sometimes took a toll on them to try to act like nothing was wrong, when they were internally struggling with depression. We recommend that research mentors treat depression like any other physical illness; allowing students the chance to recover when they are experiencing a depressive episode can be extremely important to students and can allow them to maximize their productivity upon returning to research ( Judd et al. , 2000 ). Students explained that if they are not able to take the time to focus on recovering during a depressive episode, then they typically continue to struggle with depression, which negatively affects their research. This sentiment is echoed by researchers in psychiatry who have found that patients who do not fully recover from a depressive episode are more likely to relapse and to experience chronic depression ( Judd et al. , 2000 ). Students described not doing tasks or not showing up to research because of their depression but struggling with how to share that information with their research mentors. Often, students would not say anything, which caused them anxiety because they were worried about what others in the lab would say to them when they returned. Admittedly, many students understood why this behavior would cause their research mentors to be angry or frustrated, but they weighed the consequences of their research mentors’ displeasure against the consequences of revealing their depression and decided it was not worth admitting to being depressed. This aligns with literature that suggests that when individuals have concealable stigmatized identities, or identities that can be hidden and that carry negative stereotypes, such as depression, they will often keep them concealed to avoid negative judgment or criticism ( Link and Phelan, 2001 ; Quinn and Earnshaw, 2011 ; Jones and King, 2014 ; Cooper and Brownell, 2016 ; Cooper et al. , 2019b ; Cooper et al ., unpublished data ). Therefore, it is important for research mentors to be explicit with students that 1) they recognize mental illness as a valid sickness and 2) that students with mental illness can simply explain that they are sick if they need to take time off. This may be useful to overtly state on a research website or in a research syllabus, contract, or agreement if mentors use such documents when mentoring undergraduates in their lab. Further, research mentors can purposefully work to destigmatize mental health issues by explicitly stating that struggling with mental health issues, such as depression and anxiety, is common. While we do not recommend that mentors ask students directly about depression, because this can force students to share when they are not comfortable sharing, we do recommend providing opportunities for students to reveal their depression ( Chaudoir and Fisher, 2010 ). Mentors can regularly check in with students about how they’re doing, and talk openly about the importance of mental health, which may increase the chance that students may feel comfortable revealing their depression ( Chaudoir and Quinn, 2010 ; Cooper et al ., unpublished data ).

Foster a Positive Lab Environment.

Encourage positivity in the research lab, promote working in shared spaces to enhance social support among lab members, and alleviate competition among undergraduates.

Students in this study highlighted that the “leadership” of the lab, meaning graduate students, postdocs, lab managers, and PIs, were often responsible for establishing the tone of the lab; that is, if they were in a bad mood it would trickle down and negatively affect the moods of the undergraduates. Explicitly reminding lab leadership that their moods can both positively and negatively affect undergraduates may be important in establishing a positive lab environment. Further, students highlighted how they were most likely to experience negative thoughts when they were alone in the lab. Therefore, it may be helpful to encourage all lab members to work in a shared space to enhance social interactions among students and to maximize the likelihood that undergraduates have access to help when needed. A review of 51 studies in psychiatry supported our undergraduate researchers’ perceptions that social relationships positively impacted their depression; the study found that perceived emotional support (e.g., someone available to listen or give advice), perceived instrumental support (e.g., someone available to help with tasks), and large diverse social networks (e.g., being socially connected to a large number of people) were significantly protective against depression ( Santini et al. , 2015 ). Additionally, despite forming positive relationships with other undergraduates in the lab, many undergraduate researchers admitted to constantly comparing themselves with other undergraduates, which led them to feel inferior, negatively affecting their depression. Some students talked about mentors favoring current undergraduates or talking positively about past undergraduates, which further exacerbated their feelings of inferiority. A recent study of students in undergraduate research experiences highlighted that inequitable distribution of praise to undergraduates can create negative perceptions of lab environments for students (Cooper et al. , 2019). Further, the psychology literature has demonstrated that when people feel insecure in their social environments, it can cause them to focus on a hierarchical view of themselves and others, which can foster feelings of inferiority and increase their vulnerability to depression ( Gilbert et al. , 2009 ). Thus, we recommend that mentors be conscious of their behaviors so that they do not unintentionally promote competition among undergraduates or express favoritism toward current or past undergraduates. Praise is likely best used without comparison with others and not done in a public way, although more research on the impact of praise on undergraduate researchers needs to be done. While significant research has been done on mentoring and mentoring relationships in the context of undergraduate research ( Byars-Winston et al. , 2015 ; Aikens et al. , 2017 ; Estrada et al. , 2018 ; Limeri et al. , 2019 ; NASEM, 2019 ), much less has been done on the influence of the lab environment broadly and how people in nonmentoring roles can influence one another. Yet, this study indicates the potential influence of many different members of the lab, not only their mentors, on students with depression.

Develop More Personal Relationships with Undergraduate Researchers and Provide Sufficient Guidance.

Make an effort to establish more personal relationships with undergraduates and ensure that they perceive that they have access to sufficient help and guidance with regard to their research.

When we asked students explicitly how research mentors could help create more inclusive environments for undergraduate researchers with depression, students overwhelmingly said that building mentor–student relationships would be extremely helpful. Students suggested that mentors could get to know students on a more personal level by asking about their career interests or interests outside of academia. Students also remarked that establishing a more personal relationship could help build the trust needed in order for undergraduates to confide in their research mentors about their depression, which they perceived would strengthen their relationships further because they could be honest about when they were not feeling well or their mentors might even “check in” with them in times where they were acting differently than normal. This aligns with studies showing that undergraduates are most likely to reveal a stigmatized identity, such as depression, when they form a close relationship with someone ( Chaudoir and Quinn, 2010 ). Many were intimidated to ask for research-related help from their mentors and expressed that they wished they had established a better relationship so that they would feel more comfortable. Therefore, we recommend that research mentors try to establish relationships with their undergraduates and explicitly invite them to ask questions or seek help when needed. These recommendations are supported by national recommendations for mentoring ( NASEM, 2019 ) and by literature that demonstrates that both social support (listening and talking with students) and instrumental support (providing students with help) have been shown to be protective against depression ( Santini et al. , 2015 ).

Treat Undergraduates with Respect and Remember to Praise Them.

Avoid providing harsh criticism and remember to praise undergraduates. Students with depression often have low self-esteem and are especially self-critical. Therefore, praise can help calibrate their overly negative self-perceptions.

Students in this study described that receiving criticism from others, especially harsh criticism, was particularly difficult for them given their depression. Multiple studies have demonstrated that people with depression can have an abnormal or maladaptive response to negative feedback; scientists hypothesize that perceived failure on a particular task can trigger failure-related thoughts that interfere with subsequent performance ( Eshel and Roiser, 2010 ). Thus, it is important for research mentors to remember to make sure to avoid unnecessarily harsh criticisms that make students feel like they have failed (more about failure is described in the next recommendation). Further, students with depression often have low self-esteem or low “personal judgment of the worthiness that is expressed in the attitudes the individual holds towards oneself” ( Heatherton et al. , 2003 , p. 220; Sowislo and Orth, 2013 ). Specifically, a meta-analysis of longitudinal studies found that low self-esteem is predictive of depression ( Sowislo and Orth, 2013 ), and depression has also been shown to be highly related to self-criticism ( Luyten et al. , 2007 ). Indeed, nearly all of the students in our study described thinking that they are “not good enough,” “worthless,” or “inadequate,” which is consistent with literature showing that people with depression are self-critical ( Blatt et al. , 1982 ; Gilbert et al. , 2006 ) and can be less optimistic of their performance on future tasks and rate their overall performance on tasks less favorably than their peers without depression ( Cane and Gotlib, 1985 ). When we asked students what aspects of undergraduate research helped their depression, students described that praise from their mentors was especially impactful, because they thought so poorly of themselves and they needed to hear something positive from someone else in order to believe it could be true. Praise has been highlighted as an important aspect of mentoring in research for many years ( Ashford, 1996 ; Gelso and Lent, 2000 ; Brown et al. , 2009 ) and may be particularly important for students with depression. In fact, praise has been shown to enhance individuals’ motivation and subsequent productivity ( Hancock, 2002 ; Henderlong and Lepper, 2002 ), factors highlighted by students as negatively affecting their depression. However, something to keep in mind is that a student with depression and a student without depression may process praise differently. For a student with depression, a small comment that praises the student’s work may not be sufficient for the student to process that comment as praise. People with depression are hyposensitive to reward or have reward-processing deficits ( Eshel and Roiser, 2010 ); therefore, praise may affect students without depression more positively than it would affect students with depression. Research mentors should be mindful that students with depression often have a negative view of themselves, and while students report that praise is extremely important, they may have trouble processing such positive feedback.

Normalize Failure and Be Explicit about the Importance of Research Contributions.

Explicitly remind students that experiencing failure is expected in research. Also explain to students how their individual work relates to the overall project so that they can understand how their contributions are important. It can also be helpful to explain to students why the research project as a whole is important in the context of the greater scientific community.

Experiencing failure has been thought to be a potentially important aspect of undergraduate research, because it may provide students with the potential to develop integral scientific skills such as the ability to navigate challenges and persevere ( Laursen et al. , 2010 ; Gin et al. , 2018 ; Henry et al. , 2019 ). However, in the interviews, students described that when their science experiments failed, it was particularly tough for their depression. Students’ negative reaction to experiencing failure in research is unsurprising, given recent literature that has predicted that students may be inadequately prepared to approach failure in science ( Henry et al. , 2019 ). However, the literature suggests that students with depression may find experiencing failure in research to be especially difficult ( Elliott et al. , 1997 ; Mongrain and Blackburn, 2005 ; Jones et al. , 2009 ). One potential hypothesis is that students with depression may be more likely to have fixed mindsets or more likely to believe that their intelligence and capacity for specific abilities are unchangeable traits ( Schleider and Weisz, 2018 ); students with a fixed mindset have been hypothesized to have particularly negative responses to experiencing failure in research, because they are prone to quitting easily in the face of challenges and becoming defensive when criticized ( Forsythe and Johnson, 2017 ; Dweck, 2008 ). A study of life sciences undergraduates enrolled in CUREs identified three strategies of students who adopted adaptive coping mechanisms, or mechanisms that help an individual maintain well-being and/or move beyond the stressor when faced with failure in undergraduate research: 1) problem solving or engaging in strategic planning and decision making, 2) support seeking or finding comfort and help with research, and 3) cognitive restructuring or reframing a problem from negative to positive and engaging in self encouragement ( Gin et al. , 2018 ). We recommend that, when undergraduates experience failure in science, their mentors be proactive in helping them problem solve, providing help and support, and encouraging them. Students also explained that mentors sharing their own struggles as undergraduate and graduate students was helpful, because it normalized failure. Sharing personal failures in research has been recommended as an important way to provide students with psychosocial support during research ( NASEM, 2019 ). We also suggest that research mentors take time to explain to students why their tasks in the lab, no matter how small, contribute to the greater research project ( Cooper et al. , 2019a ). Additionally, it is important to make sure that students can explain how the research project as a whole is contributing to the scientific community ( Gin et al. , 2018 ). Students highlighted that contributing to something important was really helpful for their depression, which is unsurprising, given that studies have shown that meaning in life or people’s comprehension of their life experiences along with a sense of overarching purpose one is working toward has been shown to be inversely related to depression ( Steger, 2013 ).

Limitations and Future Directions

This work was a qualitative interview study intended to document a previously unstudied phenomenon: depression in the context of undergraduate research experiences. We chose to conduct semistructured interviews rather than a survey because of the need for initial exploration of this area, given the paucity of prior research. A strength of this study is the sampling approach. We recruited a national sample of 35 undergraduates engaged in undergraduate research at 12 different public R1 institutions. Despite our representative sample from R1 institutions, these findings may not be generalizable to students at other types of institutions; lab environments, mentoring structures, and interactions between faculty and undergraduate researchers may be different at other institution types (e.g., private R1 institutions, R2 institutions, master’s-granting institutions, primarily undergraduate institutions, and community colleges), so we caution against making generalizations about this work to all undergraduate research experiences. Future work could assess whether students with depression at other types of institutions have similar experiences to students at research-intensive institutions. Additionally, we intentionally did not explore the experiences of students with specific identities owing to our sample size and the small number of students in any particular group (e.g., students of a particular race, students with a graduate mentor as the primary mentor). We intend to conduct future quantitative studies to further explore how students’ identities and aspects of their research affect their experiences with depression in undergraduate research.

The students who participated in the study volunteered to be interviewed about their depression; therefore, it is possible that depression is a more salient part of these students’ identities and/or that they are more comfortable talking about their depression than the average population of students with depression. It is also important to acknowledge the personal nature of the topic and that some students may not have fully shared their experiences ( Krumpal, 2013 ), particularly those experiences that may be emotional or traumatizing ( Kahn and Garrison, 2009 ). Additionally, our sample was skewed toward females (77%). While females do make up approximately 60% of students in biology programs on average ( Eddy et al. , 2014 ), they are also more likely to report experiencing depression ( American College Health Association, 2018 ; Evans et al. , 2018 ). However, this could be because women have higher rates of depression or because males are less likely to report having depression; clinical bias, or practitioners’ subconscious tendencies to overlook male distress, may underestimate depression rates in men ( Smith et al. , 2018 ). Further, females are also more likely to volunteer to participate in studies ( Porter and Whitcomb, 2005 ); therefore, many interview studies have disproportionately more females in the data set (e.g., Cooper et al. , 2017 ). If we had been able to interview more male students, we might have identified different findings. Additionally, we limited our sample to life sciences students engaged in undergraduate research at public R1 institutions. It is possible that students in other majors may have different challenges and opportunities for students with depression, as well as different disciplinary stigmas associated with mental health.

In this exploratory interview study, we identified a variety of ways in which depression in undergraduates negatively affected their undergraduate research experiences. Specifically, we found that depression interfered with students’ motivation and productivity, creativity and risk-taking, engagement and concentration, and self-perception and socializing. We also identified that research can negatively affect depression in undergraduates. Experiencing failure in research can exacerbate student depression, especially when students do not have access to adequate guidance. Additionally, being alone or having negative interactions with others in the lab worsened students’ depression. However, we also found that undergraduate research can positively affect students’ depression. Research can provide a familiar space where students can feel as though they are contributing to something meaningful. Additionally, students reported that having access to adequate guidance and a social support network within the research lab also positively affected their depression. We hope that this work can spark conversations about how to make undergraduate research experiences more inclusive of students with depression and that it can stimulate additional research that more broadly explores the experiences of undergraduate researchers with depression.

Important note

If you or a student experience symptoms of depression and want help, there are resources available to you. Many campuses provide counseling centers equipped to provide students, staff, and faculty with treatment for depression, as well as university-dedicated crisis hotlines. Additionally, there are free 24/7 services such as Crisis Text Line, which allows you to text a trained live crisis counselor (Text “CONNECT” to 741741; Text Depression Hotline , 2019 ), and phone hotlines such as the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). You can also learn more about depression and where to find help near you through the Anxiety and Depression Association of American website: https://adaa.org ( Anxiety and Depression Association of America, 2019 ) and the Depression and Biopolar Support Alliance: http://dbsalliance.org ( Depression and Biopolar Support Alliance, 2019 ).

ACKNOWLEDGMENTS

We are extremely grateful to the undergraduate researchers who shared their thoughts and experiences about depression with us. We acknowledge the ASU LEAP Scholars for helping us create the original survey and Rachel Scott for her helpful feedback on earlier drafts of this article. L.E.G. was supported by a National Science Foundation (NSF) Graduate Fellowship (DGE-1311230) and K.M.C. was partially supported by a Howard Hughes Medical Institute (HHMI) Inclusive Excellence grant (no. 11046) and an NSF grant (no. 1644236). Any opinions, findings, conclusions, or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the NSF or HHMI.

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Submitted: 4 November 2019 Revised: 24 February 2020 Accepted: 6 March 2020

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Home » 500+ Qualitative Research Titles and Topics

500+ Qualitative Research Titles and Topics

Table of Contents

Qualitative research is a methodological approach that involves gathering and analyzing non-numerical data to understand and interpret social phenomena. Unlike quantitative research , which emphasizes the collection of numerical data through surveys and experiments, qualitative research is concerned with exploring the subjective experiences, perspectives, and meanings of individuals and groups. As such, qualitative research topics can be diverse and encompass a wide range of social issues and phenomena. From exploring the impact of culture on identity formation to examining the experiences of marginalized communities, qualitative research offers a rich and nuanced perspective on complex social issues. In this post, we will explore some of the most compelling qualitative research topics and provide some tips on how to conduct effective qualitative research.

Qualitative Research Titles

Qualitative research titles often reflect the study’s focus on understanding the depth and complexity of human behavior, experiences, or social phenomena. Here are some examples across various fields:

“Understanding the Impact of Project-Based Learning on Student Engagement in High School Classrooms: A Qualitative Study”
“Navigating the Transition: Experiences of International Students in American Universities”
“The Role of Parental Involvement in Early Childhood Education: Perspectives from Teachers and Parents”
“Exploring the Effects of Teacher Feedback on Student Motivation and Self-Efficacy in Middle Schools”
“Digital Literacy in the Classroom: Teacher Strategies for Integrating Technology in Elementary Education”
“Culturally Responsive Teaching Practices: A Case Study in Diverse Urban Schools”
“The Influence of Extracurricular Activities on Academic Achievement: Student Perspectives”
“Barriers to Implementing Inclusive Education in Public Schools: A Qualitative Inquiry”
“Teacher Professional Development and Its Impact on Classroom Practice: A Qualitative Exploration”
“Student-Centered Learning Environments: A Qualitative Study of Classroom Dynamics and Outcomes”
“The Experience of First-Year Teachers: Challenges, Support Systems, and Professional Growth”
“Exploring the Role of School Leadership in Fostering a Positive School Culture”
“Peer Relationships and Learning Outcomes in Cooperative Learning Settings: A Qualitative Analysis”
“The Impact of Social Media on Student Learning and Engagement: Teacher and Student Perspectives”
“Understanding Special Education Needs: Parent and Teacher Perceptions of Support Services in Schools

Health Science

“Living with Chronic Pain: Patient Narratives and Coping Strategies in Managing Daily Life”
“Healthcare Professionals’ Perspectives on the Challenges of Rural Healthcare Delivery”
“Exploring the Mental Health Impacts of COVID-19 on Frontline Healthcare Workers: A Qualitative Study”
“Patient and Family Experiences of Palliative Care: Understanding Needs and Preferences”
“The Role of Community Health Workers in Improving Access to Maternal Healthcare in Rural Areas”
“Barriers to Mental Health Services Among Ethnic Minorities: A Qualitative Exploration”
“Understanding Patient Satisfaction in Telemedicine Services: A Qualitative Study of User Experiences”
“The Impact of Cultural Competence Training on Healthcare Provider-Patient Communication”
“Navigating the Transition to Adult Healthcare Services: Experiences of Adolescents with Chronic Conditions”
“Exploring the Use of Alternative Medicine Among Patients with Chronic Diseases: A Qualitative Inquiry”
“The Role of Social Support in the Rehabilitation Process of Stroke Survivors”
“Healthcare Decision-Making Among Elderly Patients: A Qualitative Study of Preferences and Influences”
“Nurse Perceptions of Patient Safety Culture in Hospital Settings: A Qualitative Analysis”
“Experiences of Women with Postpartum Depression: Barriers to Seeking Help”
“The Impact of Nutrition Education on Eating Behaviors Among College Students: A Qualitative Approach”
“Understanding Resilience in Survivors of Childhood Trauma: A Narrative Inquiry”
“The Role of Mindfulness in Managing Work-Related Stress Among Corporate Employees: A Qualitative Study”
“Coping Mechanisms Among Parents of Children with Autism Spectrum Disorder”
“Exploring the Psychological Impact of Social Isolation in the Elderly: A Phenomenological Study”
“Identity Formation in Adolescence: The Influence of Social Media and Peer Groups”
“The Experience of Forgiveness in Interpersonal Relationships: A Qualitative Exploration”
“Perceptions of Happiness and Well-Being Among University Students: A Cultural Perspective”
“The Impact of Art Therapy on Anxiety and Depression in Adult Cancer Patients”
“Narratives of Recovery: A Qualitative Study on the Journey Through Addiction Rehabilitation”
“Exploring the Psychological Effects of Long-Term Unemployment: A Grounded Theory Approach”
“Attachment Styles and Their Influence on Adult Romantic Relationships: A Qualitative Analysis”
“The Role of Personal Values in Career Decision-Making Among Young Adults”
“Understanding the Stigma of Mental Illness in Rural Communities: A Qualitative Inquiry”
“Exploring the Use of Digital Mental Health Interventions Among Adolescents: A Qualitative Study”
“The Psychological Impact of Climate Change on Young Adults: An Exploration of Anxiety and Action”
“Navigating Identity: The Role of Social Media in Shaping Youth Culture and Self-Perception”
“Community Resilience in the Face of Urban Gentrification: A Case Study of Neighborhood Change”
“The Dynamics of Intergenerational Relationships in Immigrant Families: A Qualitative Analysis”
“Social Capital and Economic Mobility in Low-Income Neighborhoods: An Ethnographic Approach”
“Gender Roles and Career Aspirations Among Young Adults in Conservative Societies”
“The Stigma of Mental Health in the Workplace: Employee Narratives and Organizational Culture”
“Exploring the Intersection of Race, Class, and Education in Urban School Systems”
“The Impact of Digital Divide on Access to Healthcare Information in Rural Communities”
“Social Movements and Political Engagement Among Millennials: A Qualitative Study”
“Cultural Adaptation and Identity Among Second-Generation Immigrants: A Phenomenological Inquiry”
“The Role of Religious Institutions in Providing Community Support and Social Services”
“Negotiating Public Space: Experiences of LGBTQ+ Individuals in Urban Environments”
“The Sociology of Food: Exploring Eating Habits and Food Practices Across Cultures”
“Work-Life Balance Challenges Among Dual-Career Couples: A Qualitative Exploration”
“The Influence of Peer Networks on Substance Use Among Adolescents: A Community Study”

Business and Management

“Navigating Organizational Change: Employee Perceptions and Adaptation Strategies in Mergers and Acquisitions”
“Corporate Social Responsibility: Consumer Perceptions and Brand Loyalty in the Retail Sector”
“Leadership Styles and Organizational Culture: A Comparative Study of Tech Startups”
“Workplace Diversity and Inclusion: Best Practices and Challenges in Multinational Corporations”
“Consumer Trust in E-commerce: A Qualitative Study of Online Shopping Behaviors”
“The Gig Economy and Worker Satisfaction: Exploring the Experiences of Freelance Professionals”
“Entrepreneurial Resilience: Success Stories and Lessons Learned from Failed Startups”
“Employee Engagement and Productivity in Remote Work Settings: A Post-Pandemic Analysis”
“Brand Storytelling: How Narrative Strategies Influence Consumer Engagement”
“Sustainable Business Practices: Stakeholder Perspectives in the Fashion Industry”
“Cross-Cultural Communication Challenges in Global Teams: Strategies for Effective Collaboration”
“Innovative Workspaces: The Impact of Office Design on Creativity and Collaboration”
“Consumer Perceptions of Artificial Intelligence in Customer Service: A Qualitative Exploration”
“The Role of Mentoring in Career Development: Insights from Women in Leadership Positions”
“Agile Management Practices: Adoption and Impact in Traditional Industries”

Environmental Studies

“Community-Based Conservation Efforts in Tropical Rainforests: A Qualitative Study of Local Perspectives and Practices”
“Urban Sustainability Initiatives: Exploring Resident Participation and Impact in Green City Projects”
“Perceptions of Climate Change Among Indigenous Populations: Insights from Traditional Ecological Knowledge”
“Environmental Justice and Industrial Pollution: A Case Study of Community Advocacy and Response”
“The Role of Eco-Tourism in Promoting Conservation Awareness: Perspectives from Tour Operators and Visitors”
“Sustainable Agriculture Practices Among Smallholder Farmers: Challenges and Opportunities”
“Youth Engagement in Climate Action Movements: Motivations, Perceptions, and Outcomes”
“Corporate Environmental Responsibility: A Qualitative Analysis of Stakeholder Expectations and Company Practices”
“The Impact of Plastic Pollution on Marine Ecosystems: Community Awareness and Behavioral Change”
“Renewable Energy Adoption in Rural Communities: Barriers, Facilitators, and Social Implications”
“Water Scarcity and Community Adaptation Strategies in Arid Regions: A Grounded Theory Approach”
“Urban Green Spaces: Public Perceptions and Use Patterns in Megacities”
“Environmental Education in Schools: Teachers’ Perspectives on Integrating Sustainability into Curricula”
“The Influence of Environmental Activism on Policy Change: Case Studies of Grassroots Campaigns”
“Cultural Practices and Natural Resource Management: A Qualitative Study of Indigenous Stewardship Models”

Anthropology

“Kinship and Social Organization in Matrilineal Societies: An Ethnographic Study”
“Rituals and Beliefs Surrounding Death and Mourning in Diverse Cultures: A Comparative Analysis”
“The Impact of Globalization on Indigenous Languages and Cultural Identity”
“Food Sovereignty and Traditional Agricultural Practices Among Indigenous Communities”
“Navigating Modernity: The Integration of Traditional Healing Practices in Contemporary Healthcare Systems”
“Gender Roles and Equality in Hunter-Gatherer Societies: An Anthropological Perspective”
“Sacred Spaces and Religious Practices: An Ethnographic Study of Pilgrimage Sites”
“Youth Subcultures and Resistance: An Exploration of Identity and Expression in Urban Environments”
“Cultural Constructions of Disability and Inclusion: A Cross-Cultural Analysis”
“Interethnic Marriages and Cultural Syncretism: Case Studies from Multicultural Societies”
“The Role of Folklore and Storytelling in Preserving Cultural Heritage”
“Economic Anthropology of Gift-Giving and Reciprocity in Tribal Communities”
“Digital Anthropology: The Role of Social Media in Shaping Political Movements”
“Migration and Diaspora: Maintaining Cultural Identity in Transnational Communities”
“Cultural Adaptations to Climate Change Among Coastal Fishing Communities”

Communication Studies

“The Dynamics of Family Communication in the Digital Age: A Qualitative Inquiry”
“Narratives of Identity and Belonging in Diaspora Communities Through Social Media”
“Organizational Communication and Employee Engagement: A Case Study in the Non-Profit Sector”
“Cultural Influences on Communication Styles in Multinational Teams: An Ethnographic Approach”
“Media Representation of Women in Politics: A Content Analysis and Audience Perception Study”
“The Role of Communication in Building Sustainable Community Development Projects”
“Interpersonal Communication in Online Dating: Strategies, Challenges, and Outcomes”
“Public Health Messaging During Pandemics: A Qualitative Study of Community Responses”
“The Impact of Mobile Technology on Parent-Child Communication in the Digital Era”
“Crisis Communication Strategies in the Hospitality Industry: A Case Study of Reputation Management”
“Narrative Analysis of Personal Stories Shared on Mental Health Blogs”
“The Influence of Podcasts on Political Engagement Among Young Adults”
“Visual Communication and Brand Identity: A Qualitative Study of Consumer Interpretations”
“Communication Barriers in Cross-Cultural Healthcare Settings: Patient and Provider Perspectives”
“The Role of Internal Communication in Managing Organizational Change: Employee Experiences”

Information Technology

“User Experience Design in Augmented Reality Applications: A Qualitative Study of Best Practices”
“The Human Factor in Cybersecurity: Understanding Employee Behaviors and Attitudes Towards Phishing”
“Adoption of Cloud Computing in Small and Medium Enterprises: Challenges and Success Factors”
“Blockchain Technology in Supply Chain Management: A Qualitative Exploration of Potential Impacts”
“The Role of Artificial Intelligence in Personalizing User Experiences on E-commerce Platforms”
“Digital Transformation in Traditional Industries: A Case Study of Technology Adoption Challenges”
“Ethical Considerations in the Development of Smart Home Technologies: A Stakeholder Analysis”
“The Impact of Social Media Algorithms on News Consumption and Public Opinion”
“Collaborative Software Development: Practices and Challenges in Open Source Projects”
“Understanding the Digital Divide: Access to Information Technology in Rural Communities”
“Data Privacy Concerns and User Trust in Internet of Things (IoT) Devices”
“The Effectiveness of Gamification in Educational Software: A Qualitative Study of Engagement and Motivation”
“Virtual Teams and Remote Work: Communication Strategies and Tools for Effectiveness”
“User-Centered Design in Mobile Health Applications: Evaluating Usability and Accessibility”
“The Influence of Technology on Work-Life Balance: Perspectives from IT Professionals”

Tourism and Hospitality

“Exploring the Authenticity of Cultural Heritage Tourism in Indigenous Communities”
“Sustainable Tourism Practices: Perceptions and Implementations in Small Island Destinations”
“The Impact of Social Media Influencers on Destination Choice Among Millennials”
“Gastronomy Tourism: Exploring the Culinary Experiences of International Visitors in Rural Regions”
“Eco-Tourism and Conservation: Stakeholder Perspectives on Balancing Tourism and Environmental Protection”
“The Role of Hospitality in Enhancing the Cultural Exchange Experience of Exchange Students”
“Dark Tourism: Visitor Motivations and Experiences at Historical Conflict Sites”
“Customer Satisfaction in Luxury Hotels: A Qualitative Study of Service Excellence and Personalization”
“Adventure Tourism: Understanding the Risk Perception and Safety Measures Among Thrill-Seekers”
“The Influence of Local Communities on Tourist Experiences in Ecotourism Sites”
“Event Tourism: Economic Impacts and Community Perspectives on Large-Scale Music Festivals”
“Heritage Tourism and Identity: Exploring the Connections Between Historic Sites and National Identity”
“Tourist Perceptions of Sustainable Accommodation Practices: A Study of Green Hotels”
“The Role of Language in Shaping the Tourist Experience in Multilingual Destinations”
“Health and Wellness Tourism: Motivations and Experiences of Visitors to Spa and Retreat Centers”

Qualitative Research Topics

Qualitative Research Topics are as follows:

Understanding the lived experiences of first-generation college students
Exploring the impact of social media on self-esteem among adolescents
Investigating the effects of mindfulness meditation on stress reduction
Analyzing the perceptions of employees regarding organizational culture
Examining the impact of parental involvement on academic achievement of elementary school students
Investigating the role of music therapy in managing symptoms of depression
Understanding the experience of women in male-dominated industries
Exploring the factors that contribute to successful leadership in non-profit organizations
Analyzing the effects of peer pressure on substance abuse among adolescents
Investigating the experiences of individuals with disabilities in the workplace
Understanding the factors that contribute to burnout among healthcare professionals
Examining the impact of social support on mental health outcomes
Analyzing the perceptions of parents regarding sex education in schools
Investigating the experiences of immigrant families in the education system
Understanding the impact of trauma on mental health outcomes
Exploring the effectiveness of animal-assisted therapy for individuals with anxiety
Analyzing the factors that contribute to successful intergenerational relationships
Investigating the experiences of LGBTQ+ individuals in the workplace
Understanding the impact of online gaming on social skills development among adolescents
Examining the perceptions of teachers regarding technology integration in the classroom
Analyzing the experiences of women in leadership positions
Investigating the factors that contribute to successful marriage and long-term relationships
Understanding the impact of social media on political participation
Exploring the experiences of individuals with mental health disorders in the criminal justice system
Analyzing the factors that contribute to successful community-based programs for youth development
Investigating the experiences of veterans in accessing mental health services
Understanding the impact of the COVID-19 pandemic on mental health outcomes
Examining the perceptions of parents regarding childhood obesity prevention
Analyzing the factors that contribute to successful multicultural education programs
Investigating the experiences of individuals with chronic illnesses in the workplace
Understanding the impact of poverty on academic achievement
Exploring the experiences of individuals with autism spectrum disorder in the workplace
Analyzing the factors that contribute to successful employee retention strategies
Investigating the experiences of caregivers of individuals with Alzheimer’s disease
Understanding the impact of parent-child communication on adolescent sexual behavior
Examining the perceptions of college students regarding mental health services on campus
Analyzing the factors that contribute to successful team building in the workplace
Investigating the experiences of individuals with eating disorders in treatment programs
Understanding the impact of mentorship on career success
Exploring the experiences of individuals with physical disabilities in the workplace
Analyzing the factors that contribute to successful community-based programs for mental health
Investigating the experiences of individuals with substance use disorders in treatment programs
Understanding the impact of social media on romantic relationships
Examining the perceptions of parents regarding child discipline strategies
Analyzing the factors that contribute to successful cross-cultural communication in the workplace
Investigating the experiences of individuals with anxiety disorders in treatment programs
Understanding the impact of cultural differences on healthcare delivery
Exploring the experiences of individuals with hearing loss in the workplace
Analyzing the factors that contribute to successful parent-teacher communication
Investigating the experiences of individuals with depression in treatment programs
Understanding the impact of childhood trauma on adult mental health outcomes
Examining the perceptions of college students regarding alcohol and drug use on campus
Analyzing the factors that contribute to successful mentor-mentee relationships
Investigating the experiences of individuals with intellectual disabilities in the workplace
Understanding the impact of work-family balance on employee satisfaction and well-being
Exploring the experiences of individuals with autism spectrum disorder in vocational rehabilitation programs
Analyzing the factors that contribute to successful project management in the construction industry
Investigating the experiences of individuals with substance use disorders in peer support groups
Understanding the impact of mindfulness meditation on stress reduction and mental health
Examining the perceptions of parents regarding childhood nutrition
Analyzing the factors that contribute to successful environmental sustainability initiatives in organizations
Investigating the experiences of individuals with bipolar disorder in treatment programs
Understanding the impact of job stress on employee burnout and turnover
Exploring the experiences of individuals with physical disabilities in recreational activities
Analyzing the factors that contribute to successful strategic planning in nonprofit organizations
Investigating the experiences of individuals with hoarding disorder in treatment programs
Understanding the impact of culture on leadership styles and effectiveness
Examining the perceptions of college students regarding sexual health education on campus
Analyzing the factors that contribute to successful supply chain management in the retail industry
Investigating the experiences of individuals with personality disorders in treatment programs
Understanding the impact of multiculturalism on group dynamics in the workplace
Exploring the experiences of individuals with chronic pain in mindfulness-based pain management programs
Analyzing the factors that contribute to successful employee engagement strategies in organizations
Investigating the experiences of individuals with internet addiction disorder in treatment programs
Understanding the impact of social comparison on body dissatisfaction and self-esteem
Examining the perceptions of parents regarding childhood sleep habits
Analyzing the factors that contribute to successful diversity and inclusion initiatives in organizations
Investigating the experiences of individuals with schizophrenia in treatment programs
Understanding the impact of job crafting on employee motivation and job satisfaction
Exploring the experiences of individuals with vision impairments in navigating public spaces
Analyzing the factors that contribute to successful customer relationship management strategies in the service industry
Investigating the experiences of individuals with dissociative amnesia in treatment programs
Understanding the impact of cultural intelligence on intercultural communication and collaboration
Examining the perceptions of college students regarding campus diversity and inclusion efforts
Analyzing the factors that contribute to successful supply chain sustainability initiatives in organizations
Investigating the experiences of individuals with obsessive-compulsive disorder in treatment programs
Understanding the impact of transformational leadership on organizational performance and employee well-being
Exploring the experiences of individuals with mobility impairments in public transportation
Analyzing the factors that contribute to successful talent management strategies in organizations
Investigating the experiences of individuals with substance use disorders in harm reduction programs
Understanding the impact of gratitude practices on well-being and resilience
Examining the perceptions of parents regarding childhood mental health and well-being
Analyzing the factors that contribute to successful corporate social responsibility initiatives in organizations
Investigating the experiences of individuals with borderline personality disorder in treatment programs
Understanding the impact of emotional labor on job stress and burnout
Exploring the experiences of individuals with hearing impairments in healthcare settings
Analyzing the factors that contribute to successful customer experience strategies in the hospitality industry
Investigating the experiences of individuals with gender dysphoria in gender-affirming healthcare
Understanding the impact of cultural differences on cross-cultural negotiation in the global marketplace
Examining the perceptions of college students regarding academic stress and mental health
Analyzing the factors that contribute to successful supply chain agility in organizations
Understanding the impact of music therapy on mental health and well-being
Exploring the experiences of individuals with dyslexia in educational settings
Analyzing the factors that contribute to successful leadership in nonprofit organizations
Investigating the experiences of individuals with chronic illnesses in online support groups
Understanding the impact of exercise on mental health and well-being
Examining the perceptions of parents regarding childhood screen time
Analyzing the factors that contribute to successful change management strategies in organizations
Understanding the impact of cultural differences on international business negotiations
Exploring the experiences of individuals with hearing impairments in the workplace
Analyzing the factors that contribute to successful team building in corporate settings
Understanding the impact of technology on communication in romantic relationships
Analyzing the factors that contribute to successful community engagement strategies for local governments
Investigating the experiences of individuals with attention deficit hyperactivity disorder (ADHD) in treatment programs
Understanding the impact of financial stress on mental health and well-being
Analyzing the factors that contribute to successful mentorship programs in organizations
Investigating the experiences of individuals with gambling addictions in treatment programs
Understanding the impact of social media on body image and self-esteem
Examining the perceptions of parents regarding childhood education
Analyzing the factors that contribute to successful virtual team management strategies
Investigating the experiences of individuals with dissociative identity disorder in treatment programs
Understanding the impact of cultural differences on cross-cultural communication in healthcare settings
Exploring the experiences of individuals with chronic pain in cognitive-behavioral therapy programs
Analyzing the factors that contribute to successful community-building strategies in urban neighborhoods
Investigating the experiences of individuals with alcohol use disorders in treatment programs
Understanding the impact of personality traits on romantic relationships
Examining the perceptions of college students regarding mental health stigma on campus
Analyzing the factors that contribute to successful fundraising strategies for political campaigns
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Understanding the impact of social support on mental health and well-being among the elderly
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Investigating the experiences of individuals with opioid use disorders in treatment programs
Understanding the impact of emotional intelligence on leadership effectiveness
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Examining the perceptions of college students regarding campus safety and security measures
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Investigating the experiences of individuals with anxiety disorders in cognitive-behavioral therapy programs
Understanding the impact of socioeconomic status on access to healthcare
Examining the perceptions of parents regarding childhood screen time usage
Analyzing the factors that contribute to successful supply chain management strategies
Understanding the impact of parenting styles on child development
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Analyzing the factors that contribute to successful crisis management strategies in organizations
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Exploring the experiences of individuals with chronic illnesses in healthcare navigation
Analyzing the factors that contribute to successful community engagement strategies for non-profit organizations
Investigating the experiences of individuals with physical disabilities in the workplace
Understanding the impact of childhood trauma on adult mental health
Analyzing the factors that contribute to successful supply chain sustainability strategies
Investigating the experiences of individuals with personality disorders in dialectical behavior therapy programs
Understanding the impact of gender identity on mental health treatment seeking behaviors
Exploring the experiences of individuals with schizophrenia in community-based treatment programs
Analyzing the factors that contribute to successful project team management strategies
Investigating the experiences of individuals with obsessive-compulsive disorder in exposure and response prevention therapy programs
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Examining the perceptions of college students regarding academic integrity
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Investigating the experiences of individuals with anxiety disorders in exposure therapy programs
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Understanding the impact of cognitive-behavioral therapy on social anxiety disorder
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Analyzing the factors that contribute to successful leadership in business organizations
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Examining the perceptions of teachers regarding inclusive education for students with disabilities
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Understanding the impact of workplace culture on employee retention and turnover
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Analyzing the factors that contribute to successful crisis communication strategies in organizations
Investigating the experiences of individuals with anxiety disorders in mindfulness-based interventions
Investigating the experiences of individuals with chronic illnesses in healthcare settings
Understanding the impact of technology on work-life balance
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Analyzing the factors that contribute to successful entrepreneurship in small businesses
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Examining the perceptions of individuals with disabilities regarding accessibility in public spaces
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Exploring the experiences of individuals with chronic illnesses in complementary and alternative medicine treatments
Analyzing the factors that contribute to successful customer retention strategies in business organizations
Investigating the experiences of individuals with postpartum depression in therapy programs
Understanding the impact of ageism on older adults in healthcare settings
Examining the perceptions of students regarding online learning during the COVID-19 pandemic
Analyzing the factors that contribute to successful team building in virtual work environments
Investigating the experiences of individuals with gambling disorders in treatment programs
Exploring the experiences of individuals with chronic illnesses in peer support groups
Analyzing the factors that contribute to successful social media marketing strategies for businesses
Investigating the experiences of individuals with ADHD in treatment programs
Understanding the impact of sleep on cognitive and emotional functioning
Examining the perceptions of individuals with chronic illnesses regarding healthcare access and affordability
Investigating the experiences of individuals with borderline personality disorder in dialectical behavior therapy programs
Understanding the impact of social support on caregiver well-being
Exploring the experiences of individuals with chronic illnesses in disability activism
Analyzing the factors that contribute to successful cultural competency training programs in healthcare settings
Understanding the impact of personality disorders on interpersonal relationships
Examining the perceptions of healthcare providers regarding the use of telehealth services
Investigating the experiences of individuals with dissociative disorders in therapy programs
Understanding the impact of gender bias in hiring practices
Exploring the experiences of individuals with visual impairments in the workplace
Analyzing the factors that contribute to successful diversity and inclusion programs in the workplace
Understanding the impact of online dating on romantic relationships
Examining the perceptions of parents regarding childhood vaccination
Analyzing the factors that contribute to successful communication in healthcare settings
Understanding the impact of cultural stereotypes on academic achievement
Exploring the experiences of individuals with substance use disorders in sober living programs
Analyzing the factors that contribute to successful classroom management strategies
Understanding the impact of social support on addiction recovery
Examining the perceptions of college students regarding mental health stigma
Analyzing the factors that contribute to successful conflict resolution in the workplace
Understanding the impact of race and ethnicity on healthcare access and outcomes
Exploring the experiences of individuals with post-traumatic stress disorder in treatment programs
Analyzing the factors that contribute to successful project management strategies
Understanding the impact of teacher-student relationships on academic achievement
Analyzing the factors that contribute to successful customer service strategies
Investigating the experiences of individuals with social anxiety disorder in treatment programs
Understanding the impact of workplace stress on job satisfaction and performance
Exploring the experiences of individuals with disabilities in sports and recreation
Analyzing the factors that contribute to successful marketing strategies for small businesses
Investigating the experiences of individuals with phobias in treatment programs
Understanding the impact of culture on attitudes towards mental health and illness
Examining the perceptions of college students regarding sexual assault prevention
Analyzing the factors that contribute to successful time management strategies
Investigating the experiences of individuals with addiction in recovery support groups
Understanding the impact of mindfulness on emotional regulation and well-being
Exploring the experiences of individuals with chronic pain in treatment programs
Analyzing the factors that contribute to successful conflict resolution in romantic relationships
Investigating the experiences of individuals with autism spectrum disorder in social skills training programs
Understanding the impact of parent-child communication on adolescent substance use
Examining the perceptions of parents regarding childhood mental health services
Analyzing the factors that contribute to successful fundraising strategies for non-profit organizations
Investigating the experiences of individuals with chronic illnesses in support groups
Understanding the impact of personality traits on career success and satisfaction
Exploring the experiences of individuals with disabilities in accessing public transportation
Analyzing the factors that contribute to successful team building in sports teams
Investigating the experiences of individuals with chronic pain in alternative medicine treatments
Understanding the impact of stigma on mental health treatment seeking behaviors
Examining the perceptions of college students regarding diversity and inclusion on campus.

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Acta Biomed
v.92(3); 2021

A breakthrough in research on depression screening: from validation to efficacy studies

Luigi costantini.

1 Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy

Alessandra Costanza

2 Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland

3 Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy

4 Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy

Andrea Aguglia

5 Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy

6 IRCCS Ospedale Policlinico San Martino, Genoa, Italy

Andrea Escelsior

Gianluca serafini, mario amore, andrea amerio.

In the last two decades the awareness of depression as a public health issue has increased and the literature has flourished towards its primary and secondary prevention. Whereas timely targeting of depression risk factors is a frontier towards reducing the incidence of the disorder, nowadays the early diagnosis is of primary importance. Screening depressive disorders is paramount, since there are several types of depression. Besides, early diagnosis would improve the outcome of treatment, reduce the frequency of relapses and generally lead to higher levels of quality of life. We highlight the feasibility of depression screening in primary care and the need of a comprehensive public health approach. ( www.actabiomedica.it )

Introduction

Depression affects more than two hundred sixty million people across the world and is a leading cause of disability ( 1 ). The estimated prevalence of depressive disorders in 2016 was 3,627 per 100,000 and in the last decade the number of all-age years lived with disability (YLDs) increased of 14% ( 2 , 3 ). Resulting from a complex interaction of social, psychological and biological factors, depressive symptoms first appear during the late teens to mid-20s, they are often overlooked and untreated and they are accompanied by poor functioning. At its worst, depression can lead to suicide, the second leading cause of death in 15-29-year-olds ( 4 , 5 ).

Depressive disorders are independent risk factors for chronic diseases, such as cardiovascular diseases and diabetes, and are associated with elevated risk of early death ( 6 , 7 ). In 2016, depressive disorders caused the loss of an overall age-adjusted rate of 526 per 100,000 disability-adjusted life years (DALYs), being the most contributor to DALYs loss among mental and behavioural disorders ( 2 ). Encouraging self-care and positive lifestyle changes especially in vulnerable segments of population can help improve, resolve or prevent depression ( 8 , 9 ).

Reduced educational achievements, poor financial success and role performance, higher amount of days out of role, and increased risk of job loss represent the social costs of depression ( 10 ). Depressive disorders bring about direct and indirect costs ( 11 ). The overall costs of depression in Europe lay around €92 billion a year, much of which caused by loss of productivity ( 12 ).

In the last two decades the awareness of depression as a public health issue has increased and the literature has flourished towards its primary and secondary prevention ( 13 ). Whereas timely targeting of depression risk factors is a frontier towards reducing the incidence of the disorder, nowadays the early diagnosis is of primary importance ( 14 ).

Screening depressive disorders is paramount, as there are several types of depression that can affect the most vulnerable individuals ( 15 , 16 ).

For example, bipolar disorder usually presents with depressive symptoms and it is common to misidentify it with major depressive disorder, a diagnosis that can negatively influence the pharmacological treatment worsening the course of illness ( 17 ) and promoting mood instability especially in presence of comorbidities ( 18 - 20 ).

Therefore, early diagnosis would improve the outcome of treatment, reduce the frequency of relapses and generally lead to higher levels of quality of life.

The present paper would like to highlight the feasibility of depression screening in primary care and the need of a comprehensive public health approach in order to develop an in-field knowledge of the real outcomes of depression screening.

Is depression screening feasible?

In the last two decades, different screening tools have been validated in primary care settings. Recent systematic reviews and meta-analyses provided an overview to the psychometric properties of widely applied depression screening tools defining the Patient Health Questionnaire 9 (PHQ-9) as the most valid one in terms of sensitivity and specificity ( 21 , 22 ). Short Likert-scale questionnaire, like PHQ-9 and PHQ-8, have been successfully used ( 23 ), while scarce evidence accounts for the widespread primary care use of ultra-short screening tools (i.e. PHQ-2) ( 21 ).

Screening tools are rather easy to use, since they consist in structured questionnaires charted either by health care professionals, caregivers, or patients themselves. PHQ-9 is being used in higher income countries as well as in the lower ones ( 21 ). Depression screening fits the need of low-resource settings by promoting the task sharing ( 24 ).

Theoretically speaking, depression screening implies very low costs, since the process could be easily performed in the context of the routine activity of general practices. Nevertheless, few studies analysed the cost-effectiveness of the screening process.

Some researchers rose concerns on the lack of evidence of screening harmlessness: the psychological consequences of a false positive, as well as the risks and costs of over-diagnosis, require careful in-field analysis ( 25 ).

Standardising the diagnostic approach to psychiatric disorders is challenging. The more common screening tools have been developed for adult patients use in Western, high-income countries. Discrepancies have therefore come to light between rigid symptom definitions and different framework of illness depending on the social and cultural background as well as the age of the patients ( 26 , 27 ). Screening tools are flexible enough to be adapted to specific situations.

However, homogeneity must be a priority in order to produce high quality evidence.

The answer to the issues above, and many others, go along with two assumptions. First, screening is useless without in-depth diagnostic confirmation. The results of screening should never be proposed as a diagnosis. On the contrary, the screening process should always include the referral to a Mental Health Professional. Second, our knowledge of screening functioning is limited by the lack of longitudinal studies. Cross-sectional studies have been able to widely validate the screening tools in different countries. From now on, research should be directed toward a better comprehension of the impact of the screening on the efficacy of treatment and the quality of health services.

Screening: a first step against stigma and toward curing

Depression is a pathology largely still affected by stigma in many cultures ( 2 ). The administration of a questionnaire might help primary care practitioners to break the wall of stigma.

Screening tools, as the PHQ-9, offer a clear description of the main features of depressive disorders. Patients charting the questionnaire might discover aspects of the illness they have never known. Thus, patients would be able to recognize depressive symptoms in themselves and others and act as caregivers. PHQ-9 administration to adolescents highlighted the increased self-awareness of depressive symptoms ( 27 ). Therefore, depression screening might become a direct way towards therapeutic education, health literacy and patients’ empowerment.

Directions for future research

The accuracy of screening tools has been already widely investigated ( 21 ). Actual research questions are represented by the efficacy of screening protocols, the impact of screening on patients’ life and the cost-effectiveness of a widespread screening program.

It is clear that cross-sectional studies are not adequate to answer those questions and longitudinal protocols must be implemented. Screening protocols should be standardised in order to increase homogeneity across different studies ( 20 ). Some lessons can be learned from the literature to be applied in future studies.

The available literature suggests the use of PHQ-8 as a standard screening tool for depression in primary care ( 23 ). PHQ-8 is widely used, straightforward and highly consistent with the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders. A two-stage screening model has been implemented by several studies and should be adopted. Semi-structured diagnostic interview, i.e., the SCID and the SCAN, performed the most accurate diagnoses ( 28 ).

The questionnaire can be charted either by the patients themselves or by general practitioners, health care professionals, and lay health workers. The demographic questionnaire should include the past medical history with special stress on mental disorders, known depression risk factors as housing, instruction, employment, and health insurance coverage. Questionnaires should be adapted to be easily understood by all the patients, according to their age, culture and educational level.

Longitudinal protocols should include the most appropriate treatment for each case. Patients should be followed up and outcomes as reduction of morbidity and mortality, reduced DALYs, and increased social functioning, should be measured. The general practitioners would have a key role in explaining the process, revising the screening results, deepening the clinical investigation and reassuring about the possibility of false positives.

Digital technologies have been effectively implemented in only few studies ( 29 ). Technology could streamline procedures and make screening sustainable to the organizational needs of primary care practices and speed up data processing ( 30 ). Organizational factors, cost-effectiveness and compliance predictors should be properly included in research protocols.

Conclusions

The gap in evidence of primary care depression screening concerns its efficacy rather than its validity or safety. Different skills are necessary to produce high quality scientific evidence. We encourage epidemiologists, psychiatrists, and general practitioners to team up, in accordance with the translational research approach, to address the research questions about depression prevention.

Acknowledgements:

This work was developed within the framework of the DINOGMI Department of Excellence of MIUR 2018-2022 (Law 232/2016).

Conflicts of interest:

Each author declares that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article.

Author contributions:

Authors LC, AC, AO, AAg, AE, and AAm wrote the first draft of the manuscript. GS and MA carefully revised the final version of the manuscript. Our manuscript has been approved by all authors.

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Qualitative Research in Mental Health and Mental Illness

Cite this chapter.

Rebecca Gewurtz Ph.D. O.T. Reg. (Ont.) 6 ,
Sandra Moll Ph.D. O.T. Reg. (Ont.) 6 ,
Jennifer M. Poole M.S.W., Ph.D. 7 &
Karen Rebeiro Gruhl Ph.D., M.Sc. O.T. OT. Reg. (Ont) 8

Part of the book series: Handbooks in Health, Work, and Disability ((SHHDW,volume 4))

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In this chapter we present an overview of qualitative research in the mental health field. We provide an historical account of the vital role that qualitative methods have played in the development of theoretical and practice approaches of psychiatry, and their current use in contemporary mental health practice. We consider how different approaches to qualitative research are used to advance knowledge and understanding of mental health, mental illness, and related services and systems, as well as the contributions of qualitative research to the mental health field. We then provide a synthesis of evidence derived from qualitative research within the mental health sector, spanning four key areas: (1) recovery, (2) stigma, (3) employment, and (4) housing. We conclude this chapter with a review of the ongoing challenges facing qualitative researchers in this area.

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Qualitative Research

Introduction: Qualitative Research in Mental Health—Innovation and Collaboration

Qualitative Research Methods in Health Services Research

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Gewurtz, R., Moll, S., Poole, J.M., Gruhl, K.R. (2016). Qualitative Research in Mental Health and Mental Illness. In: Olson, K., Young, R., Schultz, I. (eds) Handbook of Qualitative Health Research for Evidence-Based Practice. Handbooks in Health, Work, and Disability, vol 4. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2920-7_13

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As the evidence base for the study of mental health problems develops, there is a need for increasingly rigorous and systematic research methodologies. Complex questions require complex methodological approaches. Recognising this, the MRC guidelines for developing and testing complex interventions place qualitative methods as integral to each stage of intervention development and implementation. However, mental health research has lagged behind many other healthcare specialities in using qualitative methods within its evidence base. Rigour in qualitative research raises many similar issues to quantitative research and also some additional challenges. This article examines the role of qualitative methods within mental heath research, describes key methodological and analytical approaches and offers guidance on how to differentiate between poor and good quality qualitative research.

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The trajectory of qualitative methods in mental health research

Qualitative methodologies have a clear home within the study of mental health research. Early and, arguably, seminal work into the study of mental illnesses and their management was based on detailed observation, moving towards theory using inductive reasoning. Case studies have been long established in psychiatry to present detailed analysis of unusual cases or novel treatments. Participant observation was the principle method used in Goffman's seminal study of psychiatric patients in asylums that informed his ideas about the institutionalising and medicalising of mental illness by medical practice. 1 However, the 20th century saw the ‘behaviourist revolution’, a movement where quantification and experimentation dominated. Researchers sought to identify cause and effects, and reasoning became more deductive – seeking to use data to confirm theory. The study of health and illness was determined by contemporary thinking about disease, taking a biomedical stance. Psychologists and clinical health researchers exploited natural science methodologies, attempting to measure phenomenon in their smallest entities and do so as objectively as possible. This reductionist and positivist philosophy shaped advances in research methods and meant that qualitative exploration failed to develop as a credible scientific approach. Indeed, ‘objectivity’ and the ‘discovery of truth’ have become synonymous with ‘scientific enquiry’ and qualitative methods are easily dismissed as ‘anecdotal’. The underlying epistemology of this approach chimes well with medical practice for which training is predominately in laboratory and basic sciences (such as physics and chemistry) within which the discourse of natural laws dominate. To this end, research in psychiatry still remains overwhelmingly quantitative. 2

Underlying all research paradigms are assumptions. However, most traditional researchers remain unaware of these until they start to use alternative paradigms. Key assumptions of quantitative research are that facts exist that can be quantified and measured and that these should be examined, as far as possible, objectively, partialling out or controlling for the context within which they exist. There are research questions within mental health where this approach can hold: where phenomenon of interest can be reliably and meaningfully quantified and measured, it is feasible to use data to test predictions and examine change. However, for many questions these assumptions prove unsatisfying. It is often not possible or desirable to try and create laboratory conditions for the research; indeed it would be ecologically invalid to do so. For example, to understand the experience of an individual who has been newly diagnosed with schizophrenia, it is clearly important to consider the context within which they live, their family, social grouping and media messages they are exposed to. Table 1 depicts the key differences between the two methodological approaches and core underlying assumptions for each.

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Comparison of underlying assumptions of quantitative and qualitative research approaches

It should be cautioned that it is easy to fall into the trap of categorising studies as either quantitative or qualitative. The two traditions are often positioned within the literature as opposing and in conflict. This division is unhelpful and likely to impede methodological advancement. Though, undeniably, there are differences in the two approaches to research, there are also many exceptions that expose this dichotomy to be simplistic: some qualitative studies seek to test a priori hypotheses, and some quantitative studies are atheoretical and exploratory. 3 Hence it is more useful to consider research methodologies as lying along a spectrum and that researchers should be familiar with the full range of methodologies, so that a method is chosen according to the research question rather than the researcher's ability.

Rationale for qualitative methods in current mental health research

There are a number of scientific, practical and ethical reasons why mental health is an area that can particularly benefit from qualitative enquiry. Mental health research is complex. Health problems are multifactorial in their aetiology and the consequences they have on the individual, families and societies. Management can involve self-help, pharmacological, educative, social and psychotherapeutic approaches. Services involved are often multidisciplinary and require liaison between a number of individuals including professionals, service-users and relatives. Many problems are exacerbated by poor treatment compliance and lack of access to, or engagement with, appropriate services. 4

Engagement with mental health research can also be challenging. Topics may be highly sensitive or private. Individuals may have impaired capacity or be at high risk. During the research process there may be revelations of suicidal ideation or criminal activity. Hence mental health research can raise additional ethical issues. In other cases scepticism of services makes for reluctant research participants. However, if we accept the case that meaningful research can be based in subjective enquiry then qualitative methods provide a way of giving voice to participants. Qualitative methods offer an effective way of involving service-users in developing interventions for mental health problems 5 ensuring that the questions asked are meaningful to individuals. This may be particularly beneficial if participants are stakeholders, for example potential users of a new service.

Qualitative methods are valuable for individuals who have limited literacy skills who struggle with pencil and paper measures. For example qualitative research has proved fruitful in understanding children's concepts of mental illness and associated services. 6

How qualitative enquiry is used within mental health research

There are a range of types of research question where qualitative methods prove useful – from the development and testing of theory, to the piloting and establishing efficacy of treatment approaches, to understanding issues around translation and implementation into routine practice. Each is discussed in turn.

Development and testing of theory

Qualitative methods are important in exploratory work and in generating understanding of a phenomenon, stimulating new ideas or building new theory. For example, stigma is a concept that is recognised as a barrier to accessing services and also an added burden to mental health. A focus-group study sought to understand the meaning of stigma from the perspectives of individuals with schizophrenia, their relatives and health professionals. 7 From this they developed a four-dimensional theory which has subsequently informed interventions to reduce stigma and discrimination that target not only engagement with psychiatric services but also interactions with the public and work. 7

Development of tools and measures

Qualitative methods access personal accounts, capturing how individuals talk about a lived experience. This can be invaluable for designing new research tools. For example, Mavaddat and colleagues used focus groups with 56 patients with severe or common mental health problems to explore their experiences of primary care management. 8 Nine focus groups were conducted and analysis identified key themes. From these, items were generated to form a Patient Experience Questionnaire, of which the psychometric properties were subsequently examined quantitatively in a larger sample. Not only can dimensions be identified, the rich qualitative data provide terminology that is meaningful to service users that can then be incorporated into question items.

Development and testing of interventions

As we have seen, qualitative methods can inform the development of new interventions. The gold-standard methodology for investigating treatment effectiveness is the randomised controlled trial (RCT), with the principle output being an effect size or demonstration that the primary outcome was significantly improved for participants in the intervention arm compared with those in the control/comparison arm. Nevertheless, what will be familiar for researchers and clinicians involved in trials is that immense research and clinical learning arises from these substantial, often lengthy and expensive research endeavours. Qualitative methods provide a means to empirically capture these lessons, whether they are about recruitment, therapy training/supervision, treatment delivery or content. These data are essential to improve the feasibility and acceptability of further trials and developing the intervention. Conducting qualitative work prior to embarking on an RCT can inform the design, delivery and recruitment, as well as engage relevant stakeholders early in the process; all of these can prevent costly errors. Qualitative research can also be used during a trial to identify reasons for poor recruitment: in one RCT, implementing findings from this type of investigation led to an increased randomisation rate from 40% to 70%. 9

Nesting qualitative research within a trial can be viewed as taking out an insurance policy as data are generated which can later help explain negative or surprising findings. A recent trial of reattribution training for GPs to manage medically unexplained symptoms demonstrated substantial improvements in GP consultation behaviour. 10 However, effects on clinical outcomes were counterintuitive. A series of nested qualitative studies helped shed light as to why this was the case: patients' illness models were complex, and they resisted engaging with GPs (who they perceived as having more simplistic and dualistic understanding) because they were anxious it would lead to non-identification or misdiagnosis of any potential future disease 11 , an issue that can be addressed in future interventions. Even if the insights are unsurprising to those involved in the research, the data collected have been generated systematically and can be subjected to peer review and disseminated. For this reason, there is an increasing expectation from funding bodies that qualitative methodologies are integral to psychosocial intervention research.

Translation and implementation into clinical practice

Trials provide limited information about how treatments can be implemented into clinical practice or applied to another context. Psychological interventions are more effective when delivered within trial settings by experts involved in their development than when they are delivered within clinical settings. 12 Qualitative methods can help us understand how to implement research findings into routine practice. 13

Understanding what stakeholders value about a service and what barriers exist to its uptake is another evidence base to inform clinicians' practice. Relapse prevention is an effective psychoeducation approach that helps individuals with bipolar disorder extend time to relapse. Qualitative methodologies identified which aspects of the intervention service-users and care-coordinators value, and hence, are likely to utilise in routine care. 14 The intervention facilitated better understanding of bipolar disorder (by both parties), demonstrating, in turn, a rationale for medication. Patients discovered new, empowering and less socially isolated ways of managing their symptoms, which had important impacts on interactions with healthcare staff and family members. Furthermore, care-coordinators' reported how they used elements of the intervention when working with clients with other diagnoses. The research also provided insights as to where difficulties may occur when implementing a particular intervention into routine care. For example, for care-coordinators this proved a novel way of working with clients that was more emotionally demanding, thus highlighting the need for supervision and managerial support. 14

Beginners guide to qualitative approaches: one size doesn't fit all

Just as there is a range of quantitative research designs and statistical analyses to choose from, so there are many types of qualitative methods. Choosing a method can be daunting to an inexperienced or beginner-level qualitative researcher, for it requires engaging with new terms and ways of thinking about knowledge. The following summary sets out analytic and data-generation approaches that are used commonly in mental health research. It is not intended to be comprehensive and is provided only as a point of access/familiarisation to researchers less familiar with the literature.

Data generation

Qualitative data are generated in several ways. Most commonly, researchers seek a sample and conduct a series of individual in-depth interviews, seeking participants' views on topics of interest. Typically these last upwards of 45 min and are organised on the basis of a schedule of topics identified from the literature or pilot work. This does not act as a questionnaire, however; rather, it acts as a flexible framework for exploring areas of interest. The researcher combines open questions to elicit free responses, with focused questions for probing and prompting participants to provide effective responses. Usually interviews are audio-recorded and transcribed verbatim for subsequent analysis.

As interviews are held in privately, and on one-to-one basis, they provide scope to develop a trusting relationship so that participants are comfortable disclosing socially undesirable views. For example, in a study of practice nurses views of chronic fatigue syndrome, some nurses described patients as lazy or illegitimate – a view that challenges the stereotype of a nursing professional as a sympathetic and caring person. 15 This gives important information about the education and supervision required to enable or train general nurses to ensure that they are capable of delivering psychological interventions for these types of problems.

Alternatively, groups of participants are brought together for a focus group, which usually lasts for 2 hours. Although it is tempting to consider focus groups as an efficient way of acquiring data from several participants simultaneously, there are disadvantages. They are difficult to organise for geographically dispersed or busy participants, and there are compromises to confidentiality, particularly within ‘captive’ populations (eg, within an organisation individuals may be unwilling to criticise). Group dynamics must be considered; the presence of a dominant or self-professed expert can inhibit the group and, therefore, prevent useful data generation. When the subject mater is sensitive, individuals may be unwilling to discuss experiences in a group, although it often promotes a shared experience that can be empowering. Most of these problems are avoided by careful planning of the group composition and ensuring the group is conducted by a highly skilled facilitator. Lester and colleagues 16 used focus-group sessions with patients and health professionals to understand the experience of dealing with serious mental illness. Though initially participants were observed via focus-group sessions that used patient-only and health professional only groups, subsequently on combined focus groups were used that contained both patients and health professionals. 16 The primary advantage of focus groups is that they enable generation of data about how individuals discuss and interact about a phenomenon; thus, a well-conducted focus group can be an extremely rich source of data.

A different type of data are naturally occurring dialogue and behaviours. These may be recorded through observation and detailed field notes (see ethnography in Table 2 ) or analysed from audio/ video-recordings. Other data sources include texts, for example, diaries, clinical notes, Internet blogs and so on. Qualitative data can even be generated through postal surveys. We thematically analysed responses to an open-ended question set within a survey about medical educators' views of behavioural and social sciences (BSS). 17 From this, key barriers to integrating BSS within medical training were identified, which included an entrenched biomedical mindset. The themes were analysed in relation to existing literature and revealed that despite radical changes in medical training, the power of the hidden curriculum persists. 17

Key features of a range of analytical approaches used within mental health research

Analysing qualitative data

Researchers bring a wide range of analytical approaches to the data. A comprehensive and detailed discussion of the philosophy underlying different methods is beyond the scope of this paper; however, a summary of the key analytical approaches used in mental health research are provided in Table 2 . An illustrative example is provided for each approach to offer some insight into the commonalities and differences between methodologies. The procedure for analysis for all methods involves successive stages of data familiarisation/immersion, followed by seeking and reviewing patterns within the data, which may then be defined and categorized as specific themes. Researchers move back and forth between data generation and analysis, confirming or disconfirming emerging ideas. The relationship of the analysis to theory-testing or theory-building depends on the methodology used.

Some approaches are more common in healthcare than others. Interpretative phenomenological (lPA) analysis and thematic analysis have proved particularly popular. In contrast, ethnographic research requires a high level of researcher investment and reflexivity and can prove challenging for NHS ethic committees. Consequently, it remains under used in healthcare research.

Recruitment and sampling

Quantitative research is interested in identifying the typical, or average. By contrast, qualitative research aims to discover and examine the breadth of views held within a community. This includes extreme or deviant views and views that are absent. Consequently, qualitative researchers do not necessarily (though in some circumstances they may) seek to identify a representative sample. Instead, the aim may be to sample across the range of views. Hence, qualitative research can comment on what views exist and what this means, but it is not possible to infer the proportions of people from the wider population that hold a particular view.

However, sampling for a qualitative study is not any less systematic or considered. In a quantitative study one would take a statistical approach to sampling, for example, selecting a random sample or recruiting consecutive referrals, or every 10th out-patient attendee. Qualitative studies, instead, often elect to use theoretical means to identify a sample. This is often purposive; that is, the researcher uses theoretical principles to choose the attributes of included participants. Healey and colleagues conducted a study to understand the reasons for individuals with bipolar disorder misusing substances. 18 They sought to include participants who were current users of each substance group, and the recruitment strategy evolved to actively target specific cases.

Qualitative studies typically use far smaller samples than quantitative studies. The number varies depending on the richness of the data yielded and the type of analytic approach that can range from a single case to more than 100 participants. As with all research, it is unethical to recruit more participants than needed to address the question at hand; a qualitative sample should be sufficient for thematic saturation to be achieved from the data.

Ensuring that findings are valid and generalisable

A common question from individuals new to qualitative research is how can findings from a study of few participants be generalised to the wider population? In some circumstances, findings from an individual study (quantitative or qualitative) may have limited generalisability; therefore, more studies may need to be conducted, in order to build local knowledge that can then be tested or explored across similar groups. 4 However, all qualitative studies should create new insights that have theoretical or clinical relevance which enables the study to extend understanding beyond the individual participants and to the wider population. In some cases, this can lead to generation of new theory (see grounded theory in Table 2 ).

Reliability and validity are two important ways of ascertaining rigor in quantitative research. Qualitative research seeks to understand individual construction and, by definition, is subjective. It is unlikely, therefore, that a study could ever be repeated with exactly the same circumstances. Instead, qualitative research is concerned with the question of whether the findings are trustworthy; that is, if the same circumstances were to prevail, would the same conclusions would be drawn?

There are a number of ways to maximise trustworthiness. One is triangulation, of which there are three subtypes. Data triangulation involves using data from several sources (eg, interviews, documentation, observation). A research team may include members from different backgrounds (eg, psychology, psychiatry, sociology), enabling a range of perspectives to be used within the discussion and interpretation of the data. This is termed researcher triangulation . The final subtype, theoretical triangulation, requires using more than one theory to examine the research question. Another technique to establish the trustworthiness of the findings is to use respondent validation. Here, the final or interim analysis is presented to members of the population of interest to ascertain whether interpretations made are valid.

An important aspect of all qualitative studies is researcher reflexivity. Here researchers consider their role and how their experience and knowledge might influence the generation, analysis and interpretation of the data. As with all well-conducted research, a clear record of progress should be kept – to enable scrutiny of recruitment, data generation and development of analysis. However, transparency is particularly important in qualitative research as the concepts and views evolve and are refined during the process.

Judging quality in qualitative research

Within all fields of research there are better and worse ways of conducting a study, and range of quality in mental health qualitative research is variable. Many of the principles for judging quality in qualitative research are the same for judging quality in any other type of research. However, several guidelines have been developed to help readers, reviewers and editors who lack methodological expertise to feel more confident in appraising qualitative studies. Guidelines are a prerequisite for the relatively recent advance of methodologies for systematic reviewing of qualitative literature (see meta-synthesis in Table 2 ). Box 1 provides some key questions that should be considered while studying a qualitative report.

Box 1 Guidelines for authors and reviewers of qualitative research (adapted from Malterud 35 )

▶ Is the research question relevant and clearly stated?

Reflexivity

▶ Are the researcher's motives and background presented?

Method, sampling and data collection

▶ Is a qualitative method appropriate and justified?

▶ Is the sampling strategy clearly described and justified?

▶ Is the method for data generation fully described

▶ Are the characteristics of the sample sufficiently described?

Theoretical framework

▶ Was a theoretical framework used and stated?

▶ Are the principles and procedures for data organisation and analysis described and justified?

▶ Are strategies used to test the trustworthiness of the findings?

▶ Are the findings relevant to the aim of the study?

▶ Are data (e.g. quotes) used to support and enrich the findings?

▶ Are the conclusions directly linked to the study? Are you convinced?

▶ Do the findings have clinical or theoretical value?

▶ Are findings compared to appropriate theoretical and empirical literature?

▶ Are questions about the internal and external validity and reflexivity discussed?

▶ Are shortcomings of the design, and the implications these have on findings, examined?

▶ Are clinical/theoretical implications of the findings made?

Presentation

▶ Is the report understandable and clearly contextualised?

▶ Is it possible to distinguish between the voices of informants and researchers?

▶ Are sources from the field used and appropriately referenced?

Conclusions and future directions

Qualitative research has enormous potential within the field of mental health research, yet researchers are only beginning to exploit the range of methods they use at each stage of enquiry. Strengths of qualitative research primarily lie in developing theory and increasing understanding about effective implementation of treatments and how best to support clinicians and service users in managing mental health problems. An important development in the field is how to integrate methodological approaches to address questions. This raises a number of challenges, such as how to integrate textual and numerical data and how to reconcile different epistemologies. A distinction can be made between mixed- method design (eg, quantitative and qualitative data are gathered and findings combined within a single or series of studies) and mixed- model study, a pragmatist approach, whereby aspects of qualitative and quantitative research are combined at different stages during a research process. 19 Qualitative research is still often viewed as only a support function or as secondary to quantitative research; however, this situation is likely to evolve as more researchers gain a broader skill set.

Though it is undeniable that there has been a marked increase in the volume and quality of qualitative research published within the past two decades, mental health research has been surprisingly slow to develop, compared to other disciplines e.g. general practice and nursing, with relatively fewer qualitative research findings reaching mainstream psychiatric journals. 2 This does not appear to reflect overall editorial policy; however, it may be partly due to the lack of confidence on the part of editors and reviewers while identifying rigorous qualitative research data for further publication. 20 However, the skilled researcher should no longer find him or herself forced into a position of defending a single-methodology camp (quantitative vs qualitative), but should be equipped with the necessary methodological and analytical skills to study and interpret data and to appraise and interpret others' findings from a full range of methodological techniques.

Crawford MJ ,
Cordingley L
Dowrick C ,
Edwards S ,
↵ MRC Developing and Evaluating Complex Interventions 2008
Nelson ML ,
Quintana SM
Schulze B ,
Angermeyer MC
Mavaddat N ,
Lester HE ,
Donovan J ,
Morriss R ,
Barkham M ,
Stiles WB ,
Connell J ,
Chew-Graham C ,
England E ,
Kinderman P ,
Tashakkoria A ,
Ritchie J ,
Ssebunnya J ,
Chilvers R ,
Glasman D ,
Finlay WM ,
Strauss A ,
Hodges BD ,
Dobransky K
Dixon-Woods M ,
Fitzpatrick R ,
Espíndola CR ,

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Qualitative Literature Review of the Prevalence of Depression in Medical Students Compared to Students in Non-medical Degrees

Affiliation.

1 University of Adelaide, Adelaide, South Australia, Australia, [email protected].
PMID: 25398265
DOI: 10.1007/s40596-014-0241-5

Purpose: The purpose of this study is to review studies published in English between 1 January 2000 and 16 June 2014, in peer-reviewed journals, that have assessed the prevalence of depression, comparing medical students and non-medical students with a single evaluation method.

Method: The databases PubMed, Medline, EMBASE, PsycINFO, and Scopus were searched for eligible articles. Searches used combinations of the Medical Subject Headings medical student and depression. Titles and abstracts were reviewed to determine eligibility before full-text articles were retrieved, which were then also reviewed.

Results: Twelve studies met eligibility criteria. Non-medical groups surveyed included dentistry, business, humanities, nursing, pharmacy, and architecture students. One study found statistically significant results suggesting that medical students had a higher prevalence of depression than groups of non-medical students; five studies found statistically significant results indicating that the prevalence of depression in medical students was less than that in groups of non-medical students; four studies found no statistically significant difference, and two studies did not report on the statistical significance of their findings. One study was longitudinal, and 11 studies were cross-sectional.

Conclusion: While there are limitations to these comparisons, in the main, the reviewed literature suggests that medical students have similar or lower rates of depression compared to certain groups of non-medical students. A lack of longitudinal studies meant that potential common underlying causes could not be discerned, highlighting the need for further research in this area. The high rates of depression among medical students indicate the continuing need for interventions to reduce depression.

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Home » Research Methods » Qualitative Methods "How-To" Guides » Titles Available as e-Books

Qualitative Methods "How-To" Guides Edited by Patricia Leavy

This series provides researchers and students with step-by-step, practical instruction on established and emerging qualitative methods. Authors are leaders in their respective areas of expertise who demystify the research process and share innovative practices and invaluable insider advice. The basics of each method are addressed, including philosophical underpinnings, and guidance is offered on designing studies; generating, analyzing, interpreting, and representing data; and evaluating the quality of research. With accessible writing, robust examples, and ample pedagogical features, books in this series are ideal for use in courses or by individual researchers.

Titles Available as e-Books:

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(PDF) Preventing Depression Relapse: A Qualitative Study on the Need
(PDF) Depression Research Methodologies in the Journal of Personality
(PDF) Depression in Adolescence: From Qualitative Research to Measurement
(PDF) Qualitative study of patients’ perceptions of the quality of care
Qualitative Research on Adolescent Depression
Depression Research Paper (600 Words)

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7 Potential Research Titles About Depression
Treatment Options for Depression. The first choice for depression treatment is generally an antidepressant medication. Selective serotonin reuptake inhibitors (SSRIs) are the most popular choice because they can be quite effective and tend to have fewer side effects than other types of antidepressants.
The Experience of Depression: A Qualitative Study of Adolescents With
Dundon (2006) reviewed the current state of research in her meta-synthesis and was able to include six qualitative studies of depressed and non-depressed adolescents. All studies were carried out in North America with two more recent additions from Australia ( McCann, Lubman, & Clark, 2012 ) and the United Kingdom ( Midgley et al., 2015 ).
233 Depression Research Topics & Essay Titles + Examples
Post-natal depression is a popular form of depression in women. This paper presents an activity plan for the use of leisure as a therapeutic response to post-natal depression. Depression as It Relates to Obesity. This paper will argue that there is a positive correlation between depression and obesity.
A Qualitative Exploration of Depression in Emerging Adulthood: Disorder
Introduction. Emerging adulthood presents a paradox of, on the one hand, robust physical health and relative optimism, and on the other hand, a high risk for depressive and behavioral disorders and developmental and social vulnerability [1, 18].Emerging adults, defined herein as individuals 18-25 years of age, have the highest incidence and cumulative prevalence of depression of any age group ...
A Qualitative Study of Depression in Primary Care: Missed Opportunities
Depression is a common mental health problem leading to significant morbidity and mortality and high medical and societal costs. 1-3 The World Health Organization estimated that major depression caused more disability worldwide in 1990 than ischemic heart disease or cerebrovascular disease. 4 The prevalence of major depressive disorders in the US population aged 18 years and older has been ...
Biological, Psychological, and Social Determinants of Depression: A
A data charting form was created to capture the data elements of interest, including the authors, titles, determinants (biological, psychological, social), and the type of depression assessed by the research (e.g., major depression, depressive symptoms, depressive behaviour).
How is depression experienced around the world? A systematic review of
1. Introduction. Depression is a major global public health problem. It is the leading cause of disability, with an estimated global point prevalence of 4.7% and is the eleventh leading cause of global disease burden (Ferrari et al., 2012).While the majority of the world's population lives in non-Western countries, much of the research used to describe the clinical presentation of depression ...
Systematic Review and Meta-Synthesis: How Is Depression Experienced by
We systematically reviewed qualitative studies on adolescent depression published until 2023, updating the available research and replicating previous study on depressive-like illness in adults 14 by indexing symptoms and features reported by qualitative studies. In addition, we leveraged the knowledge provided by lived experience research by ...
Patient experiences of psychological therapy for depression: A
Background: Globally, national guidelines for depression have prioritised evidence from randomised controlled trials and quantitative meta-analyses, omitting qualitative research concerning patient experience of treatments. A review of patient experience research can provide a comprehensive overview of this important form of evidence and thus enable the voices and subjectivities of those ...
Patient experiences of psychological therapy for depression: a
Globally, national guidelines for depression have prioritised evidence from randomised controlled trials and quantitative meta-analyses, omitting qualitative research concerning patient experience of treatments. A review of patient experience research can provide a comprehensive overview of this important form of evidence and thus enable the voices and subjectivities of those affected by ...
(PDF) The Experience of Depression: A Qualitative Study ...
In qualitative research utilizing interpretative phenomenological analysis, Weitkamp et al. (2016) focused on the psychological struggles and experiences of adolescents with depression. Two key ...
100+ Mental Health Research Topic Ideas (+ Free Webinar ...
Here are a few ideas to get you started. The impact of genetics on the susceptibility to depression. Efficacy of antidepressants vs. cognitive behavioural therapy. The role of gut microbiota in mood regulation. Cultural variations in the experience and diagnosis of bipolar disorder.
The lived experience of adolescent depression: A systematic ...
Databases (PsychINFO, CINAL, MEDLINE and EMBASE) were searched in March 2022 to identify peer-reviewed qualitative studies on first-hand experiences of adolescent depression. The Joanna Briggs Institute's qualitative data extraction tool and checklist for qualitative research were used to obtain study data and assess methodological quality of ...
An Exploratory Study of Students with Depression in Undergraduate
METHODS. This study was done with an approved Arizona State University Institutional Review Board protocol #7247. In Fall 2018, we surveyed undergraduate researchers majoring in the life sciences across 25 research-intensive (R1) public institutions across the United States (specific details about the recruitment of the students who completed the survey can be found in Cooper et al.).
The Experience of Depression: A Qualitative Study of ...
There is a lack of research in health psychology on the subjective experience of adolescents with mental health disorders. The aim of this study was to explore the experience of depression and the journey into therapy of young people (YP) diagnosed with depression. Semi-structured interviews were carried out with six YP (5 female, aged 15-19).
500+ Qualitative Research Titles and Topics
Qualitative Research Topics. Qualitative Research Topics are as follows: Understanding the lived experiences of first-generation college students. Exploring the impact of social media on self-esteem among adolescents. Investigating the effects of mindfulness meditation on stress reduction. Analyzing the perceptions of employees regarding ...
A breakthrough in research on depression screening: from validation to
Introduction. Depression affects more than two hundred sixty million people across the world and is a leading cause of disability ().The estimated prevalence of depressive disorders in 2016 was 3,627 per 100,000 and in the last decade the number of all-age years lived with disability (YLDs) increased of 14% (2,3).Resulting from a complex interaction of social, psychological and biological ...
The relatives of people with depression: A systematic review and
Research on relatives of people with depression is currently dominated by a focus on "carer burden" and although such a focus can explain many relatives' experiences and daily lives, it provides very limited insight into the everyday life of a person living with someone with depression. Therefore, we scoped qualitative research on people ...
Qualitative Research in Mental Health and Mental Illness
1 Introduction. Qualitative research has played a vital role in the mental health field. From its roots in descriptive case studies to current contributions in program evaluation, policy development, and social action, qualitative research has helped shape our understanding of and responses to mental health and mental illness.
The experience of young people with depression: a qualitative study
In this study, we aimed to explore the experience of young people diagnosed with depression. Twenty-six young people were recruited from a youth mental health service. A qualitative interpretative design was used, incorporating semi-structured, audio-recorded interviews. Results provided four overlapping themes, reflecting the young people's ...
Qualitative Research Methods in Mental Health
As the evidence base for the study of mental health problems develops, there is a need for increasingly rigorous and systematic research methodologies. Complex questions require complex methodological approaches. Recognising this, the MRC guidelines for developing and testing complex interventions place qualitative methods as integral to each stage of intervention development and implementation.
"I keep it to myself": A qualitative meta‐interpretive synthesis of
Postpartum depression (PPD) ... Following an abstract and title review, of 68 total located articles, 56 articles were excluded for irrelevance to the research question, nonqualitative methodology, lack of quality, or lacking descriptive quotes within the text. ... Due to the lack of qualitative research that describes the impact of abuse on ...
A Qualitative Study of Stressors, Stress Symptoms, and Coping
<macro publication.title encode='html_tags'> Community Health, Department of ... increased rates of depression (Yorgason, Linville, & Zitzman, 2008; Dyson & Renk, 2006; ... on health, questions about what stresses students, and how they might be coping with stress, have been the foci of research study. The literature is replete with studies ...
Qualitative Literature Review of the Prevalence of Depression in
Purpose: The purpose of this study is to review studies published in English between 1 January 2000 and 16 June 2014, in peer-reviewed journals, that have assessed the prevalence of depression, comparing medical students and non-medical students with a single evaluation method. Method: The databases PubMed, Medline, EMBASE, PsycINFO, and Scopus were searched for eligible articles.
Research Methods > Qualitative Methods "How-To" Guides > Titles
Qualitative Methods "How-To" Guides Edited by Patricia Leavy. This series provides researchers and students with step-by-step, practical instruction on established and emerging qualitative methods. Authors are leaders in their respective areas of expertise who demystify the research process and share innovative practices and invaluable insider ...

7 Depression Research Paper Topic Ideas

What Is Depression?

What Research Says About the Psychology of Depression

Types of Depression

Causes of Depression

Who Is at Risk for Depression?

Depression Signs and Symptoms

How Is Depression Diagnosed?

Treatment Options for Depression

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233 Depression Research Topics & Essay Titles + Examples

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American Board of Family Medicine

A Qualitative Study of Depression in Primary Care: Missed Opportunities for Diagnosis and Education

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An Exploratory Study of Students with Depression in Undergraduate Research Experiences

INTRODUCTION

Student Interviews

Personal, Research, and Depression Demographics

Interview Analysis

The Effect of Depressive Symptoms on Undergraduate Research

The Effect of Undergraduate Research Experiences on Student Depression

Lab Environment: Relationships with Others in the Lab.