Starting antidepressant use: a qualitative synthesis of UK and Australian data

Objective To explore people's experiences of starting antidepressant treatment. Design Qualitative interpretive approach combining thematic analysis with constant comparison. Relevant coding reports from the original studies (generated using NVivo) relating to initial experiences of antidepressants were explored in further detail, focusing on the ways in which participants discussed their experiences of taking or being prescribed an antidepressant for the first time. Participants 108 men and women aged 22–84 who had taken antidepressants for depression. Setting Respondents recruited throughout the UK during 2003–2004 and 2008 and 2012–2013 and in Australia during 2010–2011. Results People expressed a wide range of feelings about initiating antidepressant use. People's attitudes towards starting antidepressant use were shaped by stereotypes and stigmas related to perceived drug dependency and potentially extreme side effects. Anxieties were expressed about starting use, and about how long the antidepressant might begin to take effect, how much it might help or hinder them, and about what to expect in the initial weeks. People worried about the possibility of experiencing adverse effects and implications for their senses of self. Where people felt they had not been given sufficient time during their consultation information or support to take the medicines, the uncertainty could be particularly unsettling and impact on their ongoing views on and use of antidepressants as a viable treatment option. Conclusions Our paper is the first to explore in-depth patient existential concerns about start of antidepressant use using multicountry data. People need additional support when they make decisions about starting antidepressants. Health professionals can use our findings to better understand and explore with patients’ their concerns before their patients start antidepressants. These insights are key to supporting patients, many of whom feel intimidated by the prospect of taking antidepressants, especially during the uncertain first few weeks of treatment.

Charabancs and Social Class in 1930s Britain

The renowned writer J. B. Priestley suggested in 1934 that the motor-coach had annihilated the old distinction between rich and poor passengers in Britain. This article considers how true this was by examining the relationship between charabancs, motor coaches and class. It shows that this important vehicle of inter-war working class mobility had a complicated relationship with class, identifying three distinct forms of this method of travel. It positions the charabanc alongside historical responses to unwelcome steamer and railway day-trippers, and examines how resorts provided separate class-based entertainment for these holidaymakers. Using the case study of a new charabancwelcoming pub, the Prospect Inn, it proposes that, in the late 1930s, some pubs were beginning to offer charabanc customers facilities that were almost the match of their middle class equivalent. Motor coaches and charabancs contributed to the process of social convergence in inter-war Britain.