Table 3 Illustrative quotes for each section of the results

Diversity in health status

'In February 2008, the patient was readmitted because she was not able to see her way out. She had enough of it. She was readmitted on a full time basis for a period of 5 months. Afterwards, she went to day care therapy. After two weeks of day care, she made a suicide attempt. This resulted immediately to a new full time readmission. During that readmission, she kept low profile because she planned to have a holiday. She would love to leave for her holiday.' (GIPPOZ 36)

''I feel well but I have to fight against it every day. It is a daily struggle not to give in to depression.' As far as the rest is concerned, the patient manages herself.' (GIPPOZ 67)

Change over time

''Actually, it goes quite well. One day goes better than the other day. Today for example, if you have a look outside the window ... it has been raining all day long.' The patient asks me what the weather is like in Leuven.' (GIPPOZ 17)

'The patient adds that these changes are present within the same day rather than being different between days.' (GIPPOZ 81)

Self-caring process

''At home, the expectations are high ... I manage but I sleep a lot. It has to go quickly once you are home again. Some things seem simple for my surroundings but for me it is quite a task.'' (GIPPOZ 61) (globally neutral appreciation)

'The transition from being admitted to home was experienced as very difficult by the patient. That should not be underestimated. She was also very emotional. Taking care of her (shopping, cooking, etc.) was all right. The most difficult thing was to fill in her time. She had too much time ... and started to worry. She needed to structure her life again. On days of day care, it was all right. The other days were more difficult for the patient.' (GIPPOZ 87) (globally neutral appreciation)

Medical care

'Day care was organized for this patient. She never went because the patient needed to pay € 100 every month for this service.' (GIPPOZ 2) (negative appreciation)

'She visits her psychiatrist every six weeks. If needed, she can visit the psychologist in hospital. She is followed up well. The patient indicates that this follow-up is a positive thing. In the past, this was not the case and she did not like that.' (GIPPOZ 87) (positive appreciation)

Return to work

'After hospital discharge, the patient followed 14 days of day care. He liked this very much as steppingstone. Because at discharge, everything is coming up to you and you wonder if you will manage. Day care took this aspect very well into account. The hospital discouraged the patient to go back to work immediately because the transition would be too big. After 14 days of day care, the patient went back to work. This transition passed smoothly.' (GIPPOZ 6) (positive appreciation)

'The pressure was too high after discharge. He had to work again full time and it had to go too fast. If he would had get more time to build up quietly, he thinks he would have managed.' (GIPPOZ 92) (negative appreciation)

Daily living

''Life is simple and everything is well structured at the hospital ward. When I was on day care, it could not cope ... I even didn't eat any more. It was no go.'' (GIPPOZ 82) (negative appreciation)

'The structure is not yet what it should be. Therefore, since two or three months, the psychiatric homecare passes by every two weeks for an hour. They try to evaluate how the patient is managing and try to bring some structure in her daily life. They ask if she is taking her medicines, if she takes care of herself ...' (GIPPOZ 89) (positive appreciation)

Symptom control

'When the patient feels bad, she calls 106 (= suicide prevention and support telephone helpline). Feeling bad means to her that she has dark and suicidal thoughts. The patient has still such ideas. In hospital, they told her that she will need to cope with those ideas. The patient hopes that one day it will be better or that she won't have those ideas any more. That way, her life would be better and more meaningful.' (GIPPOZ 44) (negative appreciation)

'It goes quite well. She tells that she is suffering quite a lot of her back for the moment (bilateral facet problem; discus problem and calf back). She visits a physiotherapist twice a week. According to the patient, the terrible back ache is associated with the stress of the past months.' (GIPPOZ 47) (positive appreciation)

Medication

'The patient has his own thoughts about the use of antidepressants. He compares them with pain killers for toothache. 'The pain killers won't make the cavity in your tooth go away. They do not take away the cause.'' (GIPPOZ 74) (neutral, appreciation)

''I don't take my antidepressants any more ... they can't get in any more. I took them several years. I become crazy of it.' He manages fairly to take his cardiovascular medicines.' (GIPPOZ 69) (negative appreciation)

'This summer, she stopped taking her medication because she felt better. Later, she relapsed. She forgot a consultation with her psychiatrist during holiday. She won't do that anymore in the future.' (GIPPOZ 33) (positive appreciation)

Personality

''Looking forward, not backward.' The patient learned to life according to what his body is saying.' (GIPPOZ 26) (positive appreciation)

''I'm feeling good. I'm a bit perfectionist. My wife warns me not to overdo myself.'' (GIPPOZ 51) (positive appreciation)

Finances

'The patient tells she cannot take care of herself. She spends too much money through which she gets in trouble all over again.' (GIPPOZ 63) (negative appreciation)

''Actually, I should visit the cardiologist and the dentist ... but yeah, that's all very expensive ...' Necessary care is postponed due to financial constraints.' (GIPPOZ 88) (negative appreciation)

Unable to work/no job

'Because of her back surgery and because she could not resume work after a certain period, the patient was sacked. The patient does not have any diplomas. She cannot do heavy work anymore. The patient is in a very difficult situation.' (GIPPOZ 59) (negative appreciation)

'Things go well at work. The patient is very happy about that. She considers her work in another way: she is much more open. She liked her job very much before but now, she likes it even more and now she knows this is really what she wants. It gives her energy.' (GIPPOZ 91) (positive appreciation)

Social relations

''Social relations are one of my difficulties', the patient tells. She says she is closing herself for everyone. This is definitely a task for her.' (GIPPOZ 44) (negative appreciation)

'The patient feels not understood by his family, even by his daughter. He cannot count on their understanding because they do not know what it means to suffer from depression. The patient admits he also could not get it right in the past. The patient tries to explain but that does not always work out. The family cannot imagine their selves well ... ' (GIPPOZ 26) (negative appreciation)

''The leisure activities are good thanks to a friend of mine who drags me everywhere.'' (GIPPOZ 89) (positive appreciation)

Leisure activities

'The patient likes to draw, to paint and to read. But when she wants to do these things, she looks around and she sees the household work. Then she has a feeling of guilt. She does not succeed in relaxing. She gives priority to the chores.' (GIPPOZ 19) (negative appreciation)

'The patient had the prospect of doing walks with young children. These walks were fantastic. He really enjoyed these walks.' (GIPPOZ 81) (positive appreciation)

Home

'After the last admission, she did not return to home. In hospital, she arranged a home in Ostend where she went straight away after her discharge. She took a new start over there. She had enough of it and did not like to return to her husband. In the mean time, they divorced. She feels much more peaceful now.' (GIPPOZ 88) (positive appreciation)

'The patient lived together with his son in a flat. Now, his son is going to life together with his girlfriend. So, he has to move now because he cannot afford this flat anymore.' (GIPPOZ 29) (negative appreciation)