Skip to main content

Table 1 Table presenting characteristics and quality appraisal of included studies

From: The experience of loneliness among young people with depression: a qualitative meta-synthesis of the literature

Citation Sample size Population studied Country Aims Data collection Analysis Themes Quality Appraisal 1–10
Al-Khattab et al. 2016 [41] 27 (15 ♂) Aged 18–21. African-American (AA) adolescents having
a) depressive symptoms during adolescence (aged 13–17). 22 participants in total
or
b) currently aged 13–17 and receiving treatment for depression. 5 participants in total
USA How AA adolescents describe symptoms of depression through relationships with people in their lives. Semi-structured interviews Thematic analysis 1) keeping others at bay
2) striking out at others
3) seeking help from others
4) joining in with others
5) having others reach out
7/10
Validity
Clear aims
Appropriate qualitative methodology
Appropriate research design
x Appropriate recruitment strategy
x Appropriate data collection
Considered reflexivity appropriately
Results
x Ethical considerations addressed
Rigorous data analysis
Clear statement of findings
Utility of results
Value of research
Anttila et al.
2015 [42]
70 (54 ♂) Aged 15–17 diagnosed with depression (outpatient) without SMI taking part in RCT for internet-based support system Finland Adolescent concerns and hopes when referred to outpatient treatment Written text/essay before intervention Thematic analysis 1) Relationships
2) Daily actions
3) Identity
4) Well-being
7/10
Validity
Clear aims
Appropriate qualitative methodology
x Appropriate research design
Appropriate recruitment strategy
x Appropriate data collection
x Considered reflexivity appropriately
Results
Ethical considerations addressed
Rigorous data analysis
Clear statement of findings
Utility of results
Value of research
De Mol et al. 2018 [24] 15 (9 ♂) Hospitalized (> 4 months) adolescents (aged 15–18) diagnosed with depression by psychiatrist after receiving outpatient psychotherapy Belgium The role of social representations in adolescents’ construction of major depression Semi-structured interviews Interpretative Phenomenological Analysis 1) Depression means personal failure
2) Feeling bad is not allowed and is not normal: in fact, depression doesn’t really exist
3) You are obliged to have an intimate relationship, otherwise you are not normal;
4) It is important to have future projects for personal and social well-being
5) Being socially well integrated is normality.
10/10
Validity
Clear aims
Appropriate qualitative methodology
Appropriate research design
Appropriate recruitment strategy
Appropriate data collection
Considered reflexivity appropriately
Results
Ethical considerations addressed
Rigorous data analysis
Clear statement of findings
Utility of results
Value of research
Dundon 2006 [43]
(metasynthesis)
107 (94 ♂) Aged 13–22. 72 diagnosed or self-reported as depression.
6 studies in total, 2 of which unpublished
USA/
Canada
Contribute to the theoretic base of the experience of adolescent depression, affect future research, and guide clinical practice. Self-reports, semi-structured interviews TA, Descriptive, narrative, Participatory action, discourse analysis, grounded research 1) Beyond the blues
2) Spiraling down and within
3) Breaking points
4) Seeing and being seen
5) Seeking solutions
6) Taking control.
5/10
Validity
Clear aims
Appropriate qualitative methodology
Appropriate research design
x Appropriate recruitment strategy
x Appropriate data collection
x Considered reflexivity appropriately
Results
Ethical considerations addressed
x Rigorous data analysis
x Clear statement of findings
Utility of results
Value of research
Farmer 2002 [44] 5 (3 ♂) 5 adolescents (aged 13–18) diagnosed with depression by therapist. USA Experience of major depression from the adolescent’s perspective to provide a more comprehensive description of the disorder. Semi-structured interviews Phenomenological approach 1) Dispirited weariness
2) Emotional homelessness (sense of aloneness)
3) Emotional homelessness
(no safety where expected)
4) Unrelenting anger
5) Parental break-up: caught in the middle
6) Spectrum of escape from pain
7) Perspectives on friendship
8) Gaining a sense of getting well
9/10
Validity
Clear aims
Appropriate qualitative methodology
Appropriate research design
Appropriate recruitment strategy
Appropriate data collection
Considered reflexivity appropriately
Results
Ethical considerations addressed
x Rigorous data analysis
Clear statement of findings
Utility of results
X Value of research
Granek 2006 [45] 6 (1 ♂) Students (aged 25–30) gone through an episode of clinical depression (meeting DSM 4 criteria) referring to that period. Didn’t meet criteria for current depression. Canada Depressive experience from a subjective perspective Open ended interviews Grounded theory/hermeneutic approach 1) Self in relation
2) Self-criticism and self-loathing
3) Loneliness and disconnection
6/10
Validity
Clear aims
Appropriate qualitative methodology
Appropriate research design
x Appropriate recruitment strategy
Appropriate data collection
Considered reflexivity appropriately
Results
x Ethical considerations addressed
x Rigorous data analysis
Clear statement of findings
Utility of results
xValue of research
Kuwabara et al.
2007 [46]
15 (10 ♂) Community sample (18–25) currently experiencing depression determined by physician interviewers (severe depression with suicidality was excluded) USA Obtain a relatively unconstrained description of the ways in which depression is construed and experienced among a sample of emerging adults. Semi-structured interviews Thematic Analysis 1) Identification as an individual with depression
2) Interactions with the healthcare system
3) Relationships with friends and family
4) Role transitions from childhood to adulthood
9/10
Validity
Clear aims
Appropriate qualitative methodology
Appropriate research design
Appropriate recruitment strategy
Appropriate data collection
Considered reflexivity appropriately
Results
x Ethical considerations addressed
Rigorous data analysis
Clear statement of findings
Utility of results
Value of research
Lachal et al.
2012 [47]
5 (3 ♂) Aged 14–17. Receiving therapy for past depressive episode, 4 participants use medication. Selected after consultation in psychiatry department. Episode was over at the time of interviewing (reflection). France How a qualitative method, using in-depth interviews with patients and clinicians, can help building a specific tool to measure depression in adolescents. Semi-structured interviews Thematic Analysis 1) Emotional state
2) Non-emotional manifestations
3) Manifestations in social interactions
6/10
Validity
Clear aims
Appropriate qualitative methodology
x Appropriate research design
Appropriate recruitment strategy
x Appropriate data collection
x Considered reflexivity appropriately
Results
Ethical considerations addressed
x Rigorous data analysis
Clear statement of findings
Utility of results
Value of research
McCann et al.
2012 [48]
26 (15 ♂) Aged 16–25. Purposeful sampling at Headspace via clinicians 1) depression as primary diagnose 2). Excluding psychosis and suicidality. 13 had double diagnose depression + anxiety Australia Examine the lived experience
of young people diagnosed with depression
Semi-structured interviews Interpretative Phenomenological Analysis 1) Struggling to make sense of their situation
2) Spiralling down
3) Withdrawing
4) Contemplating self-harm or suicide
8/10
Validity
Clear aims
Appropriate qualitative methodology
Appropriate research design
x Appropriate recruitment strategy
Appropriate data collection
x Considered reflexivity appropriately
Results
Ethical considerations addressed
Rigorous data analysis
Clear statement of findings
Utility of results
Value of research
Meadus 2007 [49] 9 (8 ♂) Aged 15–18 diagnosed with mood disorder (7 depression, 2 bipolar). Treated by psychiatrist or GP. Receiving medication. Both inpatient and outpatient. Canada Explore the phenomenon of coping as experienced by adolescents with a mood disorder Unstructured interviews Grounded theory, each interview analysed before starting the next interview 1) Feeling different
2) Cutting off connections
3) Facing the challenge /reconnecting
4) Learning from the experience
7/10
Validity
Clear aims
Appropriate qualitative methodology
Appropriate research design
x Appropriate recruitment strategy
Appropriate data collection
x Considered reflexivity appropriately
Results
Ethical considerations addressed
x Rigorous data analysis
Clear statement of findings
Utility of results
Value of research
Midgley et al. 2015 [50] 77 (55 ♂) Aged 11–17. Diagnosed with depression with moderate to severe impairment. Part of larger RCT (IMPACT study) clinically referred to child and adolescent mental health services for treatment for depression, but have yet to receive therapy UK Exploring the experience of depression in a sample
of young people aged between 11 and 17
Semi-structured interviews (before intervention, rather brief 4-37 min) Framework analysis 1) Misery, despair and tears
2) Anger and violence towards self and others
3) A bleak view of everything
4) Isolation and cutting off from the world
5) The impact on education
9/10
Validity
Clear aims
Appropriate qualitative methodology
Appropriate research design
Appropriate recruitment strategy
xAppropriate data collection
Considered reflexivity appropriately
Results
Ethical considerations addressed
Rigorous data analysis
Clear statement of findings
Utility of results
Value of research
Rosales 2008 [51]
(PhD thesis)
6 (5 ♂) Aged 12–15 and diagnosed with bipolar disorder, dysthymia, and major depression. Purposeful sampling through community counsellors and school districts professional counsellors, private therapists, school psychologists.
Students included were required to have a support system in place such as parents and peers.
USA middle school adolescents their thoughts and perceptions about their experiences with depression Semi-structured & open-ended Comparative method analysis 1) Person centred
2) Hopelessness
3) Relationships/ connections
4) isolation
5) Escape/ distractions
7/10
Validity
Clear aims
Appropriate qualitative methodology
Appropriate research design
xAppropriate recruitment strategy
Appropriate data collection
Considered reflexivity appropriately
Results
x Ethical considerations addressed
x Rigorous data analysis
Clear statement of findings
Utility of results
Value of research
Weitkamp et al. 2016 [52] 6 (5 ♂) Aged 14–19. Interviewed after max two sessions with therapist suffering from depressive disorder. Exclusion criteria: cognitively too impaired to participate as rated by therapist/interviewer.
All met criteria depression ICD and some with comorbidity of PTSS, anxiety and bereavement.
Germany Lived experience of young people diagnosed with depression, and additionally to look at the way these YP accessed therapy in the context of the German mental health system. Semi-structured interviews Interpretative Phenomenological analysis 1) Suffering is experienced as overwhelming
2) An experience of loneliness and isolation
3) Struggling to understand the suffering
4) Therapy as a last resort
8/10
Validity
Clear aims
Appropriate qualitative methodology
Appropriate research design
x Appropriate recruitment strategy
Appropriate data collection
Considered reflexivity appropriately
Results
x Ethical considerations addressed
Rigorous data analysis
Clear statement of findings
Utility of results
Value of research
Woodgate et al. 2006 [53] 14 (11 ♂) Aged 13–19. Outpatient diagnosed with depression for > 18 months. 12 other mental health condition as well (e.g. ADHD/substance abuse) but no other severe mental illness. Canada Gain an understanding of what it was like to be an adolescent living with depression. Open-ended interviews
&
Focus groups (same participants in groups of 6)
Hermeneutic phenomenology 1) Containing the shadow of fear
2) Keeping the self alive
3) Maintaining a sense of belonging in the world
4) Feeling valued as a human being
6/10
Validity
Clear aims
Appropriate qualitative methodology
Appropriate research design
x Appropriate recruitment strategy
Appropriate data collection
x Considered reflexivity appropriately
Results
Ethical considerations addressed
x Rigorous data analysis
x Clear statement of findings
Utility of results
Value of research