Differences in depressed oncologic patients’ narratives after receiving two different therapeutic interventions for depression: a qualitative study Beatriz Rodr 1 ´guez Vega 1 *, Pablo Orgaz Barnier 4 , Carmen Bayón 1 , Ángela Palao 1 , Guadalupe Torres 1 , Ana Hospital 2 , Guillermo Benito 1 , Maria Dieguez 3 and Alberto Fernández Liria 3 1 Psychiatry Service, La Paz University Hospital, Madrid, Spain 2 La Paz University Hospital, Madrid, Spain 3 Psychiatry Service, Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain 4 Psychiatry Service, Hospital de Galdakao, Vizcaya, Spain *Correspondence to: Department of Psychiatry, La Paz University Hospital, Idipaz, Paseo de la Castellana 261, 28046 Madrid, Spain. E-mail: beatrizrvega@gmail.com Received: 30 December 2010 Revised: 19 June 2011 Accepted: 22 June 2011 Abstract Background: This study aims to explore differences in personal narratives of the experience of ill- ness and treatment in depressed oncologic patients who received either combined treatment for de- pression (psychotherapy plus antidepressants) or standard treatment (antidepressants alone). Methods: We employed a qualitative research design based on grounded theory. Data were collected from eight videotaped focus groups and semi-structured interviews with a total of 28 participants. The research team reviewed interview transcripts and categorized the partici- pants’ responses using the ATLAS.ti (ATLAS.ti Scientific Software Development GmbH Hardenbergstr. 7 D-10623, Berlin) software package. Results: Compared with patients in the standard treatment group, patients in the combined treatment group were better able to relate their experiences of physical and emotional discom- fort and find meaning in the experience of illness by viewing cancer as a transformative experi- ence. In addition, patients in the combined treatment group tended to use more active coping strategies based on acceptance of their situation and emphasized that psychotherapy had been helpful. Conclusions: Qualitative analysis is an efficient method of examining the meaning of quanti- tative results in depth, particularly patients’ perspectives on quality of life. Patients undergoing combined treatment consider psychotherapy to be a helpful tool and exhibit more personal growth than do patients undergoing standard treatment. Copyright # 2011 John Wiley & Sons, Ltd. Keywords: cancer; combined treatment; depression; narrative study; oncology; qualitative study Introduction Depression is seen frequently in cancer patients [1–3] and has a negative impact in terms of quality of life, treatment adherence, and emotional burden on caregivers [4]. Studies suggest that the most effective treatment strategies for major depression include a combination of psychotherapeutic and pharmacologic interventions [5–11], although these studies involve certain methodological limitations [12–14]. Recently, we conducted a study using a quantitative methodology and found that Narrative Therapy (NT) used in combination with antidepres- sant treatment appears to be a beneficial intervention for depression accompanying oncologic non-meta- static illness [14]. Specifically, combined treatment (NT plus antidepressants) significantly improved functional dimensions of quality of life at 12 and 24weeks post-treatment as compared to standard treatment (antidepressants alone) but did not seem to offer any additional benefit in terms of reducing depressive symptoms. In addition, combined treatment was acceptable to patients, showed good potential for dissemination, was relatively easy to implement, and improved patient compliance. Randomized clinical trials in which measurement of outcome variables is based on questionnaires with good psychometric properties are the most accepted way of testing the efficacy of new therapeutic inter- ventions. However, the use of questionnaires tends to reduce, and may not fully capture, patients’ experi- ences. Qualitative studies may be more appropriate to obtain a detailed understanding of the illness experi- ence in oncology [15] and the change process in psy- chotherapy. Indeed, some authors suggest that qualitative studies should precede or accompany quantitative studies in psychotherapy research [16]. Studies using qualitative methodology in the field Copyright # 2011 John Wiley & Sons, Ltd. Psycho-Oncology Psycho-Oncology 21: 1292–1298 (2012) Published online 1 September 2011 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/pon.2036